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Sample records for depression posttraumatic stress

  1. Depressed suicide attempters with posttraumatic stress disorder.

    Science.gov (United States)

    Ramberg, Maria; Stanley, Barbara; Ystgaard, Mette; Mehlum, Lars

    2015-01-01

    Posttraumatic stress disorder and major depressive disorder are well-established risk factors for suicidal behavior. This study compared depressed suicide attempters with and without comorbid posttraumatic stress disorder with respect to additional diagnoses, global functioning, depressive symptoms, substance abuse, history of traumatic exposure, and suicidal behavior. Adult patients consecutively admitted to a general hospital after a suicide attempt were interviewed and assessed for DSM-IV diagnosis and clinical correlates. Sixty-four patients (71%) were diagnosed with depression; of them, 21 patients (32%) had posttraumatic stress disorder. There were no group differences in social adjustment, depressive symptoms, or suicidal intent. However, the group with comorbid depression and posttraumatic stress disorder had more additional Axis I diagnoses, a higher degree of childhood trauma exposure, and more often reported previous suicide attempts, non-suicidal self-harm, and vengeful suicidal motives. These findings underline the clinical importance of diagnosis and treatment of posttraumatic stress disorder in suicide attempters.

  2. Posttraumatic stress and depression in Yazidi refugees

    Directory of Open Access Journals (Sweden)

    Nasıroğlu S

    2016-11-01

    Full Text Available Serhat Nasıroğlu,1 Veysi Çeri2 1Department of Child and Adolescent Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Turkey; 2Pendik Training and Research Hospital, Department of Child and Adolescent Psychiatry, Medical School of Marmara University, Istanbul, Turkey Aim: The aim of this investigation was to determine the frequency of mental pathologies in children and adolescents of the Yazidi minority group who immigrated to Turkey from Iraq. The refugees were asked about preventive and risk factors that occurred before and after their immigration. Subjects and methods: The sample comprised 55 children and adolescents (30 males and 25 females who were Yazidi refugees and had settled in the Uçkuyular, Oğuz, Onbaşi, and Uğurca villages of Batman, Turkey. The study was conducted 9 months after the refugees had immigrated. The participants were evaluated in their native language through a semistructured interview titled “Reliability and Validity of Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version – Turkish Version”. A sociodemographic form was prepared so that investigators could understand their traumatic experiences before and after the migration and their current social conditions. All the interviews were conducted in the participants’ native language without the help of translators. The investigators filled out the sociodemographic forms. Results: Posttraumatic stress disorder (PTSD was detected in 20 children (36.4%, depression in 18 (32.7%, nocturnal enuresis in six (10.9%, and anxiety in four (7.3%. The following factors were found to be associated with depression: witnessing violence and/or death, being a girl, having older parents, being the elder child, and having multiple siblings (P<0.05. Risk factors for PTSD, depression, and comorbid conditions included witnessing violence and/or death (P<0.05. Four participants were observed to have both PTSD and

  3. Posttraumatic stress disorder, depression, and suicide in veterans.

    Science.gov (United States)

    Sher, Leo; Braquehais, María Dolores; Casas, Miquel

    2012-02-01

    Suicidal behavior is a critical problem in war veterans. Combat veterans are not only more likely to have suicidal ideation, often associated with posttraumatic stress disorder (PTSD) and depression, but they are more likely to act on a suicidal plan. Especially since veterans may be less likely to seek help from a mental health professional, non-mental-health physicians are in a key position to screen for PTSD, depression, and suicidal ideation in these patients. The authors discuss the association of PTSD, depression, and suicide in veterans, keys to assessment of suicide risk, and interventions.

  4. [Posttraumatic Stress and Depressive Symptoms amongst Asylum Seekers].

    Science.gov (United States)

    Kröger, Christoph; Frantz, Inga; Friel, Pauline; Heinrichs, Nina

    2016-09-01

    Background and Objectives: Currently, there is a large number of refugees that are coming to Germany from (civil) war zones. The aim of this study was to estimate the extent of posttraumatic stress and depressive symptoms amongst asylum seekers in Germany. Methods: In the summer of 2015, 280 adult refugees (88,2% men) were interviewed with the support of translators in the Lower Saxony State Refugee Reception Center, Brunswick. Data was categorized due to country of origin (Balkan States, Middle East, Northern Africa, Rest of Africa). The Posttraumatic Diagnostic Scale-8 (PDS-8) and the Patient-Health-Questionnaire (PHQ-8) were employed as screening measures. If the threshold values of 12 in the PDS-8 or 15 in the PHQ are exceeded, respectively, the diagnosis of PTSD or depression is highly likely. Results: Participants reported an overall high number of potentially traumatic experiences (72,5% war experiences; 67,9% violent attacks; 51,4% another very burdensome experience; 50,0% torture; 47,9% imprisonment; 11,1% sexual assault), whereby multiple answers were possible. The prevalence rates for possible PTSD were 16,1% (Balkan States), 20,5% (Middle East), 23,4% (Rest of Africa) and 28,1% (Northern Africa); rates for a possible depression varied between the countries of origin from 17,9, 35,9, 28,1 to 24,0%, respectively. Conclusions: Compared to the German population, the rates of traumatic experiences and the prevalence of a possible PTSD were significantly higher amongst asylum seekers of the present sample; this was not the case for depression. The integration of affected asylum seekers may be considerably complicated due to health impairments, e. g. with regard to learning the German language and admission to educational or occupational services. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Changes in Posttraumatic Stress Disorder and Depressive Symptoms during Cognitive Processing Therapy: Evidence for Concurrent Change

    Science.gov (United States)

    Liverant, Gabrielle I.; Suvak, Michael K.; Pineles, Suzanne L.; Resick, Patricia A.

    2012-01-01

    Objective: Trauma-focused psychotherapies reduce both posttraumatic stress disorder (PTSD) and co-occurring depression. However, little is known about the relationship between changes in PTSD and depression during treatment. This study examined the association between changes in PTSD and depression during the course of cognitive processing therapy…

  6. A literature review of the application of the Geriatric Depression Scale, Depression Anxiety Stress Scales and Post-traumatic Stress Disorder Checklist to community nursing cohorts.

    Science.gov (United States)

    Allen, Jacqui; Annells, Merilyn

    2009-04-01

    To explore through literature review the appropriateness of three common tools for use by community nurses to screen war veteran and war widow(er) clients for depression, anxiety and post-traumatic stress disorder. War veterans and, to a lesser extent, war widow(er)s, are prone to mental health challenges, especially depression, anxiety and post-traumatic stress disorder. Community nurses do not accurately identify such people with depression and related disorders although they are well positioned to do so. The use of valid and reliable self-report tools is one method of improving nurses' identification of people with actual or potential mental health difficulties for referral to a general practitioner or mental health practitioner for diagnostic assessment and treatment. The Geriatric Depression Scale, Depression Anxiety Stress Scales and Post-traumatic Stress Disorder Checklist are frequently recommended for mental health screening but the appropriateness of using the tools for screening war veteran and war widow(er) community nursing clients who are often aged and have functional impairment, is unknown. Systematic review. Current literature informs that the Geriatric Depression Scale accurately predicts a diagnosis of depression in community nursing cohorts. The three Depression Anxiety Stress Scales subscales of depression, anxiety and stress are valid; however, no studies were identified that compared the performance of the Depression Anxiety Stress Scales in predicting diagnoses of depression or anxiety. The Post-traumatic Stress Disorder Checklist predicts post-traumatic stress disorder in community cohorts although no studies meeting the selection criteria included male participants. This review provides recommendations for the use of the Geriatric Depression Scale, Depression Anxiety Stress Scales and The Post-traumatic Stress Disorder Checklist based on examination of the published evidence for the application of these screening tools in samples

  7. Behavioral Activation in the Treatment of Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder

    Science.gov (United States)

    Mulick, Patrick S.; Naugle, Amy E.

    2009-01-01

    This study investigated the efficacy of 10-weeks of Behavioral Activation (BA) in the treatment of comorbid Post-traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) in four adults using a nonconcurrent multiple baseline across participants design. All participants met full "DSM-IV" criteria for both MDD and PTSD at the…

  8. Screening and Predicting Posttraumatic Stress and Depression in Children Following Single-Incident Trauma

    Science.gov (United States)

    Nixon, Reginald D. V.; Ellis, Alicia A.; Nehmy, Thomas J.; Ball, Shelley-Anne

    2010-01-01

    Three screening methods to predict posttraumatic stress disorder (PTSD) and depression symptoms in children following single-incident trauma were tested. Children and adolescents (N = 90; aged 7-17 years) were assessed within 4 weeks of an injury that led to hospital treatment and followed up 3 and 6 months later. Screening methods were adapted…

  9. Reduced Autobiographical Memory Specificity Predicts Depression and Posttraumatic Stress Disorder after Recent Trauma

    Science.gov (United States)

    Kleim, Birgit; Ehlers, Anke

    2008-01-01

    In this prospective longitudinal study, the authors examined the relationship between reduced specificity in autobiographical memory retrieval and the development of depression, posttraumatic stress disorder (PTSD), and specific phobia after injury in an assault. Assault survivors (N = 203) completed the Autobiographical Memory Test (J. M. G.…

  10. Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression

    NARCIS (Netherlands)

    Olff, Miranda; Polak, A Rosaura; Witteveen, Anke B; Denys, D.

    BACKGROUND: Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments

  11. Post-traumatic stress, depression, and community integration a long time after whiplash injury

    Directory of Open Access Journals (Sweden)

    Britt-Marie Stålnacke

    2010-01-01

    Full Text Available Psychological factors such as post-traumatic stress and depression may play an important role in the recovery after whiplash injuries. Difficulties in psychosocial functioning with limitations in everyday life may dominate for some time after the injury. Our study therefore investigates the relationships between pain, post-traumatic stress, depression, and community integration. A set of questionnaires was answered by 191 persons (88 men, 103 women five years after a whiplash injury to assess pain intensity (visual analogue scale, VAS, whiplash-related symptoms, post-traumatic stress (impact of event scale, IES, depression (Beck depression inventory, BDI-II, community integration (community integration questionnaire, CIQ, life satisfaction (LiSat-11. One or more depressive symptoms were reported by 74% of persons; 22% reported scores that were classified as mild to severe depression. The presence of at least one post-traumatic symptom was reported by 70% of persons, and 38% reported mild to severe stress. Total scores of community integration for women were statistically significantly higher than for men. The total VAS score was correl-ated positively to the IES (r=0.456, P less than 0.456, the BDI (r=0.646, P less than 0.001, and negatively to the CIQ (r=-0.300, P less than 0.001. These results highlight the view that a significant proportion of people experience both pain and psycho- logical difficulties for a long time after a whiplash injury. These findings should be taken into consideration in the management of subjects with chronic whiplash symptoms and may support a multi-professional rehabilitation model that integrates physical, psychological, and psychosocial factors.

  12. Posttraumatic Stress and Depressive Reactions Among Children and Adolescents After the 1999 Earthquake in Ano Liosia, Greece

    National Research Council Canada - National Science Library

    Roussos, Alexandra; Goenjian, Armen K; Steinberg, Alan M; Sotiropoulou, Christina; Kakaki, Marina; Kabakos, Christos; Karagianni, Stavroula; Manouras, Vagelis

    2005-01-01

    OBJECTIVE: This study evaluated the severity of posttraumatic stress and depressive reactions among children and adolescents 3 months after the 1999 earthquake in Ano Liosia, Greece, and additionally assessed...

  13. The role of major depression in neurocognitive functioning in patients with posttraumatic stress disorder

    OpenAIRE

    Nijdam, Mirjam J.; Gersons, Berthold P R; Olff, Miranda

    2013-01-01

    Background: Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) frequently co-occur after traumatic experiences and share neurocognitive disturbances in verbal memory and executive functioning. However, few attempts have been made to systematically assess the role of a comorbid MDD diagnosis in neuropsychological studies in PTSD.Objective: The purpose of the current study is to investigate neurocognitive deficits in PTSD patients with and without MDD. We hypothesized that...

  14. TRAUMATIC EVENTS ASSOCIATED WITH POSTTRAUMATIC STRESS DISORDER: THE ROLE OF RACE/ETHNICITY AND DEPRESSION

    OpenAIRE

    Lipsky, Sherry; Kernic, Mary A.; Qiu, Qian; Hasin, Deborah S.

    2015-01-01

    This study sought to examine specific types of potentially traumatic experiences as predictors of posttraumatic stress disorder (PTSD) and the moderating effect of race/ethnicity and major depressive disorder (MDD) among non-Hispanic White, non-Hispanic Black, and Hispanic U.S. women. The study sample was drawn from two waves of the National Epidemiologic Surveys of Alcohol and Related Conditions. Sexual assault, intimate partner violence, and childhood trauma were the strongest predictors of...

  15. THE EFFECTS OF EXPRESSIVE WRITING ON POSTPARTUM DEPRESSION AND POSTTRAUMATIC STRESS SYMPTOMS.

    Science.gov (United States)

    Blasio, Paola Di; Camisasca, Elena; Caravita, Simona Carla Silvia; Ionio, Chiara; Milani, Luca; Valtolina, Giovanni Giulio

    2015-12-01

    This study investigated whether an Expressive Writing intervention decreased depression and posttraumatic stress symptoms after childbirth. 113 women (M age = 31.26 yr., SD = 4.42) were assessed at Time 1 for depression (Beck Depression Inventory) and PTS (Perinatal PTSD Questionnaire) in the first days after childbirth, then randomized to either expressive writing or neutral writing conditions and reassessed at Time 2, 3 months later. The results (ANCOVAs, regression models) show that at 3 mo. depressive and posttraumatic symptoms were lower in women who performed the expressive writing task than in the neutral writing group. Moreover, the intervention condition was associated significantly with decreased depression at the high and at the mean levels of baseline depression at Time 1. Regarding PTSD, the results showed that the intervention condition was linked significantly to reductions of the symptoms at all levels of baseline PTSD. Mainly, these outcomes suggest that Expressive Writing can be a helpful early and low-cost universal intervention to prevent postpartum distress for women.

  16. Children's symptoms of posttraumatic stress and depression after a natural disaster: comorbidity and risk factors.

    Science.gov (United States)

    Lai, Betty S; La Greca, Annette M; Auslander, Beth A; Short, Mary B

    2013-03-20

    The current study examined rates of comorbidity among children's symptoms of posttraumatic stress (PTS) and depression after a natural disaster, Hurricane Ike. We also compared children with comorbid symptoms to children without comorbid symptoms, examining recovery, severity of symptoms, and risk factors. Children (n=277; 52% girls; 38% Hispanic, 28% White, 19% Black; grades 2-4) were assessed at 8 and 15 months postdisaster. Children completed measures of PTS and depressive symptoms at both time points and measures of exposure and recovery stressors at 8 months postdisaster. At 8 months postdisaster, 13% of children reported elevated PTS-only, 11% depression-only, and 10% comorbid symptoms of PTS and depression. At 15 months postdisaster, 7% of children reported elevated PTS-only, 11% depression-only, and 7% comorbid symptoms of PTS and depression. Children with comorbid symptoms of PTS and depression had poorer recovery, more severe symptoms, and they reported greater exposure and recovery stressors. We lacked information on children's predisaster functioning and diagnostic interview of psychological distress symptoms. Children with comorbid symptoms need to be identified early postdisaster. Levels of stressors should be monitored postdisaster, as highly stressed youth have difficulties recovering and may need help. Interventions should be tailored for children with comorbid symptoms of PTS and depression. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Impact of Maternal Posttraumatic Stress Disorder and Depression Following Exposure to the September 11 Attacks on Preschool Children's Behavior

    Science.gov (United States)

    Chemtob, Claude M.; Nomura, Yoko; Rajendran, Khushmand; Yehuda, Rachel; Schwartz, Deena; Abramovitz, Robert

    2010-01-01

    To evaluate whether conjoined maternal posttraumatic stress disorder (PTSD) and depression are associated with increased behavioral problems among terrorism-exposed preschool children (N = 116; 18-54 months), this study compared clinically significant child behavioral problem rates among the preschool children of mothers with PTSD and depression,…

  18. Identification With Terrorist Victims of the Washington, DC Sniper Attacks: Posttraumatic Stress and Depression.

    Science.gov (United States)

    Herberman Mash, Holly B; Ursano, Robert J; Benevides, K Nikki; Fullerton, Carol S

    2016-02-01

    In October 2002, a series of sniper attacks in the Washington, DC area left 10 people dead and 3 wounded. We examined the association between identification with terrorist victims and psychological and behavioral outcomes. Participants were 1,238 residents of the Washington, DC area (ages 18-90 years; M = 41.73, SD = 12.56) who completed the Impact of Event Scale-Revised, Patient Health Questionnaire-9, and items pertaining to identification with attack victims approximately 3 weeks following the first sniper shooting. We examined 3 types of identification with the victims: (a) as like oneself, (b) as like a friend, and (c) as like a family member. The relationships of identification to posttraumatic stress and depressive symptoms were examined using linear regression analyses. Greater total identification was associated with more posttraumatic stress and depressive symptoms (B = 0.27, p < .001, and B = 0.44, p < .001, respectively), after adjusting for demographics. Those who specifically identified with the victims as either self (B = 0.24, p < .001), friend (B = 0.30, p < .001), or family member (B = 0.27, p < .001) reported more PTSD symptoms (n = 1,101). Identifying with victims as like a friend or family member, but not as like oneself, was associated with increased depressive symptoms (B = 0.61, p < .001, and B = 0.45, p = .01, respectively; n = 1,222). Presence and type of identification play a differential role in psychological and behavioral responses during traumatic events.

  19. Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations.

    Science.gov (United States)

    Flory, Janine D; Yehuda, Rachel

    2015-06-01

    Approximately half of people with post-traumatic stress disorder (PTSD) also suffer from Major Depressive Disorder (MDD). The current paper examines evidence for two explanations of this comorbidity. First, that the comorbidity reflects overlapping symptoms in the two disorders. Second, that the co-occurrence of PTSD and MDD is not an artifact, but represents a trauma-related phenotype, possibly a subtype of PTSD. Support for the latter explanation is inferred from literature that examines risk and biological correlates of PTSD and MDD, including molecular processes. Treatment implications of the comorbidity are considered.

  20. Children's risk and resilience following a natural disaster: genetic vulnerability, posttraumatic stress, and depression.

    Science.gov (United States)

    La Greca, Annette M; Lai, Betty S; Joormann, Jutta; Auslander, Beth B; Short, Mary A

    2013-12-01

    We examined children's risk and resilience following a natural disaster, evaluating the role of stress, social support, and two genetic markers: the short allele of the serotonin transporter gene (5-HTTLPR), and the met allele of the Brain-Derived Neurotrophic Factor (BDNF).Under high levels of hurricane exposure or hurricane-related stressors, we expected children displaying the markers would report greater symptoms of posttraumatic stress disorder (PTSD) and depression than children without these markers. Social support was explored as an additional moderating variable. Eight months after Hurricane Ike, 116 children (M age=8.85 years, SD=.89; 54% girls) residing in Galveston, Texas, provided saliva samples and completed measures of hurricane exposure and stress, and symptoms of PTSD and depression; 80 also completed a social support measure. For BDNF, analyses revealed several Gene by Environment interactions; greater stress was related to more symptoms of PTSD and depression, and this effect was stronger for children with the met allele. No findings emerged for 5-HTTLPR. Stressors and social support also were associated with children's PTSD and depressive symptoms. Findings should be tempered by the relatively small sample, especially for analysis that included social support. The met allele (BDNF) may play a role in children's disaster reactions. Further research should consider the complex interplay between genes, stressors, support, and psychological outcomes over time. © 2013 Elsevier B.V. All rights reserved.

  1. Psychological responses after a major, fatal earthquake: the effect of peritraumatic dissociation and posttraumatic stress symptoms on anxiety and depression.

    Science.gov (United States)

    Duncan, Esma; Dorahy, Martin J; Hanna, Donncha; Bagshaw, Sue; Blampied, Neville

    2013-01-01

    Following trauma, most people with initial symptoms of stress recover, but it is important to identify those at risk for continuing difficulties so resources are allocated appropriately. There has been limited investigation of predictors of posttraumatic stress disorder following natural disasters. This study assessed psychological difficulties experienced in 101 adult treatment seekers following exposure to a significant earthquake. Peritraumatic dissociation, posttraumatic stress symptoms, anxiety, depression, and emotional support were assessed. Path analysis was used to determine whether the experience of some psychological difficulties predicted the experience of other difficulties. As hypothesized, peritraumatic dissociation was found to predict posttraumatic stress symptoms and anxiety. Posttraumatic stress symptoms then predicted anxiety and depression. Depression and anxiety were highly correlated. Contrary to expectations, emotional support was not significantly related to other psychological variables. These findings justify the provision of psychological support following a natural disaster and suggest the benefit of assessing peritraumatic dissociation and posttraumatic stress symptoms soon after the event to identify people in need of monitoring and intervention.

  2. Potentially Traumatic Events, Posttraumatic Stress Disorder, and Depression among Adults in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Cassie eOverstreet

    2016-03-01

    Full Text Available The aims of the current study were to examine the prevalence of potentially traumatic events (PTEs, posttraumatic stress disorder (PTSD; data available in males only, and depressive symptoms in a Puerto Rican sample of 678 adult caretakers (50% female of twins participating in the Puerto Rican Infant Twin Study. The World Health Organization Composite International Diagnostic Interview version 3.0 (CIDI 3.0 was utilized to assess rates of PTEs, PTSD, and depression among male participants while an abbreviated version of the CIDI 3.0 and the Mood and Feelings Questionnaire were administered to females to assess PTEs and depressive symptoms. Significantly more males than females reported exposure to a PTE (76.6% vs. 44.2%, 2=64.44, p<.001. In males, endorsement of multiple PTEs was associated with increased level of PTSD symptomatology ( = .33, p < .001. With regard to depression, a similar dose-response relationship was found in both males and females, with depressive symptoms increasing as number of PTEs increased (s = .15, .16, ps < .05. Exposure to an attack with a weapon was significantly associated with increased depression symptoms in both males and females (s=.24, .20, ps<.01, respectively. These findings highlight the need for identification of putative risk and resilience factors among PTE-exposed individuals in Puerto Rico.

  3. Impact of comorbid depression on quality of life in male combat Veterans with posttraumatic stress disorder.

    Science.gov (United States)

    Raab, Phillip A; Mackintosh, Margaret-Anne; Gros, Daniel F; Morland, Leslie A

    2015-01-01

    For Veterans with posttraumatic stress disorder (PTSD), depression is a highly comorbid condition. Both conditions have been associated with decreased quality of life, and research suggests that comorbid PTSD and depression may result in worse quality of life than PTSD alone. However, research is needed to elucidate the effect of comorbidity on a broader variety of quality of life domains. In this study, we used baseline data of 158 male combat Veterans taking part in a PTSD treatment trial and examined the unique relationships between quality of life domains and PTSD symptom clusters, major depressive disorder (MDD) diagnosis, and self-reported depressive symptoms. Veterans with comorbid PTSD-MDD reported significantly worse satisfaction-related quality of life than those with PTSD alone, although this finding was largely attributable to PTSD numbing symptoms. Subsequent analyses comparing the effect of numbing symptoms to depressive symptoms revealed that depression exerted a stronger influence, although numbing symptoms were still uniquely associated with quality of life. We discuss implications for treatment and research, as well as the need to address negative affect in Veterans with PTSD.

  4. Risk of posttraumatic stress disorder and depression in survivors of the floods in Bihar, India

    Directory of Open Access Journals (Sweden)

    Telles Shirley

    2009-08-01

    Full Text Available Background: Following a natural disaster, survivors are vulnerable to develop posttraumatic stress disorder (PTSD and/ or depression. Objectives: (i To screen survivors of the Bihar floods a month after the event to determine their scores in a screening questionnaire for PTSD and/ or depression and (ii to correlate these scores with age and gender. Materials and Methods: One thousand two hundred eighty-nine persons (645 females who had been directly exposed to the floods in Bihar, India, in August 2008 were assessed. The Screening Questionnaire for Disaster Mental Health (SQD was used to screen for PTSD and depression. Statistical Analysis: Separate two-factor ANOVAs were used to compare persons of both sexes and 5 different age groups for PTSD and depression scores. This was followed by post-hoc analysis for multiple comparisons. Results: People over the age of 60 years had significantly higher scores for PTSD and depression compared to all groups (P< 0.05 for all comparisons. Conclusion: Following a natural disaster, older people appear more vulnerable to develop PTSD and depression. This should be taken into account in devising strategies for disaster relief.

  5. Depression, posttraumatic stress disorder, and grade point average among student servicemembers and veterans.

    Science.gov (United States)

    Bryan, Craig J; Bryan, AnnaBelle O; Hinkson, Kent; Bichrest, Michael; Ahern, D Aaron

    2014-01-01

    The current study examined relationships among self-reported depression severity, posttraumatic stress disorder (PTSD) symptom severity, and grade point average (GPA) among student servicemembers and veterans. We asked 422 student servicemembers and veterans (72% male, 86% Caucasian, mean age = 36.29 yr) to complete an anonymous online survey that assessed self-reported GPA, depression severity, PTSD severity, and frequency of academic problems (late assignments, low grades, failed exams, and skipped classes). Female respondents reported a slightly higher GPA than males (3.56 vs 3.41, respectively, p = 0.01). Depression symptoms (beta weight = -0.174, p = 0.03), male sex (beta weight = 0.160, p = 0.01), and younger age (beta weight = 0.155, p = 0.01) were associated with lower GPA but not PTSD symptoms (beta weight = -0.040, p = 0.62), although the interaction of depression and PTSD symptoms showed a nonsignificant inverse relationship with GPA (beta weight = -0.378, p = 0.08). More severe depression was associated with turning in assignments late (beta weight = 0.171, p = 0.03), failed exams (beta weight = 0.188, p = 0.02), and skipped classes (beta weight = 0.254, p = 0.01). The relationship of depression with self-reported GPA was mediated by frequency of failed examns. Results suggest that student servicemembers and veterans with greater emotional distress also report worse academic performance.

  6. Health functioning impairments associated with posttraumatic stress disorder, anxiety disorders, and depression.

    Science.gov (United States)

    Zayfert, Claudia; Dums, Aricca R; Ferguson, Robert J; Hegel, Mark T

    2002-04-01

    Although anxiety disorders have been associated with impairments in self-reported health functioning, the relative effect of various anxiety disorders has not been studied. We compared health functioning of patients with a principal diagnosis of posttraumatic stress disorder (PTSD), panic disorder (PD), generalized anxiety disorder (GAD), and major depressive disorder (MDD). Patients with PTSD and MDD were equally impaired on overall mental health functioning, and both were significantly worse than patients with PD and GAD. PTSD was associated with significantly worse physical health functioning relative to PD, GAD, and MDD. Hierarchical regression showed that the association of PTSD with physical health functioning was unique and was not caused by the effects of age, depression, or comorbid anxiety disorders. Both PTSD and comorbid anxiety accounted for unique variance in mental functioning. These results highlight the association of PTSD with impaired physical and mental functioning and suggest that effective treatment of PTSD may affect overall health.

  7. Trait anxiety mediates the effect of stress exposure on post-traumatic stress disorder and depression risk in cardiac surgery patients

    NARCIS (Netherlands)

    Kok, Lotte; Sep, Milou S; Veldhuijzen, Dieuwke S; Cornelisse, Sandra; Nierich, Arno P; van der Maaten, Joost; Rosseel, Peter M; Hofland, Jan; Dieleman, Jan M; Vinkers, Christiaan H; Joëls, Marian; van Dijk, Diederik; Hillegers, Manon H

    2016-01-01

    BACKGROUND: Post-traumatic stress disorder (PTSD) and depression are common after cardiac surgery. Lifetime stress exposure and personality traits may influence the development of these psychiatric conditions. METHODS: Self-reported rates of PTSD and depression and potential determinants (i.e.,

  8. Postpartum Post-Traumatic Stress Disorder

    Science.gov (United States)

    ... Depression During Pregnancy & Postpartum Anxiety During Pregnancy & Postpartum Pregnancy or Postpartum Obsessive Symptoms Postpartum Post-Traumatic Stress Disorder Bipolar Mood Disorders Postpartum Psychosis Social Support ...

  9. Depression and posttraumatic stress disorder among HIV-infected Gambians on antiretroviral therapy.

    Science.gov (United States)

    Peterson, Kevin; Togun, Toyin; Klis, Sandor; Menten, Joris; Colebunders, Robert

    2012-10-01

    Mood disorders are more frequent among people with HIV infection than among non-HIV-infected individuals of the same age, socioeconomic status, and HIV risks. They have been associated with worse adherence and clinical outcomes, yet remain underdiagnosed and undertreated in sub-Saharan Africa. We explored the relationship between mood disorders using the 10-item depression scale of the Centers for Epidemiological Studies (CES-D10) and the 22-item Impact of Events Scale-Revised (IES-R) for posttraumatic stress disorder, and a range of demographic and HIV-related variables among 252 consecutive subjects on antiretroviral therapy (ART). The study was conducted in the Genito-Urinary Medicine Clinic of the Medical Research Council's Gambia Unit. These screening tests were positive in 7% and 30%, respectively, of the patients, with higher scores (more depression or more post-traumatic stress) associated with female gender, more advanced WHO clinical stage, and lower Karnofsky Perfomance Scale rating. Higher CES-D10 scores were also seen among those on their second ART regimen. No relationship was seen with age, time on ART, viral load, or CD4 cell count. Compared to an earlier study at the same site in subjects prior to starting ART, the prevalence of depression in those stabilized on ART was dramatically reduced (by 34%, from 41%) while that of PTSD dropped less (by 13%, from 43%). Integrating the CES-D10 or a similar instrument into patient preparation for ART is recommended in order to identify those who may benefit from further mental health investigations, specific therapy, or closer follow-up during early ART.

  10. Symptoms of Posttraumatic Stress, Depression, and Anxiety as Predictors of Suicidal Ideation among South African University Students

    Science.gov (United States)

    Bantjes, Jason R.; Kagee, Ashraf; McGowan, Taryn; Steel, Henry

    2016-01-01

    Objective: To investigate the 2-week prevalence of suicidal ideations and their associations to symptoms of posttraumatic stress, depression, and anxiety among South African university students. Participants: Data were collected from 1,337 students between May and August 2013. Methods: Hierarchical regression analysis was used to investigate the…

  11. Behavioral Activation as an Early Intervention for Posttraumatic Stress Disorder and Depression among Physically Injured Trauma Survivors

    Science.gov (United States)

    Wagner, Amy W.; Zatzick, Douglas F.; Ghesquiere, Angela; Jurkovich, Gregory J.

    2007-01-01

    This paper describes an adaptation of behavioral activation (BA) for the early intervention of posttraumatic stress disorder (PTSD) and depression among physically injured survivors of traumatic injury, and presents pilot data on a small randomized effectiveness trial (N = 8). The application of BA to PTSD is based on the theory that increases in…

  12. Posttraumatic Stress Disorder Symptom Structure in Injured Children: Functional Impairment and Depression Symptoms in a Confirmatory Factor Analysis

    Science.gov (United States)

    Kassam-Adams, Nancy; Marsac, Meghan L.; Cirilli, Carla

    2010-01-01

    Objective: To examine the factor structure of posttraumatic stress disorder (PTSD) symptoms in children and adolescents who have experienced an acute single-incident trauma, associations between PTSD symptom clusters and functional impairment, and the specificity of PTSD symptoms in relation to depression and general distress. Method: Examined…

  13. Symptoms of Posttraumatic Stress, Depression, and Anxiety as Predictors of Suicidal Ideation among South African University Students

    Science.gov (United States)

    Bantjes, Jason R.; Kagee, Ashraf; McGowan, Taryn; Steel, Henry

    2016-01-01

    Objective: To investigate the 2-week prevalence of suicidal ideations and their associations to symptoms of posttraumatic stress, depression, and anxiety among South African university students. Participants: Data were collected from 1,337 students between May and August 2013. Methods: Hierarchical regression analysis was used to investigate the…

  14. Incidental Retrieval of Emotional Contexts in Post-Traumatic Stress Disorder and Depression: An fMRI Study

    Science.gov (United States)

    Whalley, Matthew G.; Rugg, Michael D.; Smith, Adam P. R.; Dolan, Raymond J.; Brewin, Chris R.

    2009-01-01

    In the present study, we used fMRI to assess patients suffering from post-traumatic stress disorder (PTSD) or depression, and trauma-exposed controls, during an episodic memory retrieval task that included non-trauma-related emotional information. In the study phase of the task neutral pictures were presented in emotional or neutral contexts.…

  15. Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers.

    Science.gov (United States)

    Ehring, Thomas; Razik, Saiqa; Emmelkamp, Paul M G

    2011-01-30

    Past research has shown a substantial prevalence of emotional disorders in professionals involved in rescue and/or relief operations following natural disasters, including earthquakes. However, no published study to date has investigated whether disaster rehabilitation and reconstruction workers involved in later phases of the earthquake response are also affected by emotional problems. A nearly complete sample of earthquake rehabilitation and reconstruction workers (N=267) involved in the response to the 2005 earthquake in Northern Pakistan filled in a set of self-report questionnaires assessing emotional problems and predictor variables approximately 24 months after the earthquake. Most participants had experienced the disaster themselves and suffered from a number of stressors during and shortly after the acute earthquake phase. A substantial subgroup of participants reported clinically relevant levels of emotional disorders, especially earthquake-related posttraumatic stress disorder (42.6%), as well as depression and anxiety (approx. 20%). Levels of burnout were low. Symptom levels of posttraumatic stress disorder were associated with the severity of the earthquake experience, past traumas, work-related stressors, low social support, and female gender. The results document a high prevalence of emotional problems in earthquake rehabilitation and recovery workers.

  16. Depression and posttraumatic stress disorder in temporary settlement residents 1 year after the Sichuan earthquake.

    Science.gov (United States)

    Cheng, Zhang; Ma, Ning; Yang, Lei; Agho, Kingsley; Stevens, Garry; Raphael, Beverley; Cui, Lijun; Liu, Yongqiao; Yan, Baoping; Ma, Hong; Yu, Xin

    2015-03-01

    The authors sought to determine the prevalence and risk factors for major depressive disorder and posttraumatic stress disorder (PTSD) among survivors living in temporary accommodation in the Yongxing settlement in Mianyang city 1 year after the Sichuan earthquake for further interventions. They interviewed 182 residents, using the Structured Clinical Interview for DSM-IV Axis I Disorders and a self-report questionnaire. The 12-month prevalence of depressive disorder and PTSD were 48.9% and 39.6%, respectively. Multivariate analysis indicated that bereaved survivors were 5.51 times (adjusted odds ratio [AOR] = 5.51; 95% confidence interval [CI] =2.14-14.22) more likely to report PTSD and 2.42 times (AOR = 2.42; 95%CI =1.00-5.48) more likely to report depressive disorder than nonbereaved survivors. Older age and receipt of government financial support were significantly associated with 12-month PTSD. Depressive disorder 12 months after the earthquake was associated with receipt of government financial support, pre-earthquake physical illness, single marital status, being currently employed, and Han ethnicity.

  17. Posttraumatic Stress Disorder

    Science.gov (United States)

    ... Choosing the Right Sport for You Shyness Posttraumatic Stress Disorder KidsHealth > For Teens > Posttraumatic Stress Disorder Print A A A What's in this ... But for Jake and other people with posttraumatic stress disorder (PTSD), things are different. When someone has ...

  18. Influence of Spirituality on Depression, Posttraumatic Stress Disorder, and Suicidality in Active Duty Military Personnel

    Directory of Open Access Journals (Sweden)

    Laurel L. Hourani

    2012-01-01

    Full Text Available Understanding the role of spirituality as a potential coping mechanism for military personnel is important given growing concern about the mental health issues of personnel returning from war. This study seeks to determine the extent to which spirituality is associated with selected mental health problems among active duty military personnel and whether it moderates the relationship between combat exposure/deployment and (a depression, (b posttraumatic stress disorder (PTSD, and (c suicidality in active duty military personnel. Data were drawn from the 2008 Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel. Over 24,000 randomly selected active duty personnel worldwide completed an anonymous self-report questionnaire. High spirituality had a significant protective effect only for depression symptoms. Medium, as opposed to high or low, levels of spirituality buffered each of the mental health outcomes to some degree. Medium and low spirituality levels predicted depression symptoms but only among those with moderate combat exposure. Medium spirituality levels also predicted PTSD symptoms among those with moderate levels of combat exposure and predicted self-reported suicidal ideation/attempt among those never deployed. These results point to the complex relationship between spirituality and mental health, particularly among military personnel and the need for further research.

  19. Symptoms of posttraumatic stress, depression, and anxiety as predictors of suicidal ideation among South African university students.

    Science.gov (United States)

    Bantjes, Jason R; Kagee, Ashraf; McGowan, Taryn; Steel, Henry

    2016-01-01

    To investigate the 2-week prevalence of suicidal ideations and their associations to symptoms of posttraumatic stress, depression, and anxiety among South African university students. Data were collected from 1,337 students between May and August 2013. Hierarchical regression analysis was used to investigate the relationship between suicidal ideation and symptoms of posttraumatic stress, depression, and anxiety. Rates of suicidal ideation are higher among university students in South Africa than among the general population of the country and student populations in other parts of the world. Symptoms of depression and exposure to trauma predict suicidal ideation Conclusions: Findings bring into focus the high rates of suicidal ideation among a sample of university students in South African and the need for more research to investigate the psychosocial correlates of this phenomena within the cultural context of the country, especially given the correlation between suicidal ideation and other poor health outcomes.

  20. Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression.

    Science.gov (United States)

    Olff, Miranda; Polak, A Rosaura; Witteveen, Anke B; Denys, Damiaan

    2014-07-01

    Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments may be associated with comorbid depressive symptoms, but their role in executive function impairments is still unclear. To examine several domains of executive functioning in PTSD and the potentially mediating role of comorbid depressive symptoms in the relationship between executive function and PTSD. Executive functioning was assessed in 28 PTSD patients and 28 matched trauma-exposed controls. The Cambridge Neuropsychological Test Automated Battery (CANTAB) with subtests measuring response inhibition (SST), flexibility/set shifting (IED), planning/working memory (OTS) and spatial working memory (SWM) was administered in PTSD patients and trauma-exposed controls. Regression analyses were used to assess the predictive factor of PTSD symptoms (CAPS) and depressive symptoms (HADS-D) in relation to executive function when taking into account the type of trauma. Pearson's correlations were used to examine the association between PTSD symptom clusters (CAPS) and executive function. The mediating effects of depression and PTSD were assessed using regression coefficients and the Sobel's test for mediation. Our findings indicate that PTSD patients performed significantly worse on executive function than trauma-exposed controls in all domains assessed. PTSD symptoms contributed to executive functioning impairments (SST median correct, IED total errors, OTS latency to correct, SWM total errors and SWM strategy). Adding depressive symptoms to the model attenuated these effects. PTSD symptom clusters 'numbing' and to a lesser extent 'avoidance' were more frequently associated with worse executive function (i.e., IED total errors, OTS latency to correct and SWM total errors) than

  1. Depressive, anxiety and post-traumatic stress disorders at six years after occupational injuries.

    Science.gov (United States)

    Chin, Wei-Shan; Shiao, Judith Shu-Chu; Liao, Shih-Cheng; Kuo, Chun-Ya; Chen, Chih-Chieh; Guo, Yue Leon

    2017-01-02

    The aim of this study is to determine the prevalence rates of depressive, anxiety and PTSDs, and the risk factors for psychological symptoms at 6 years after occupational injury. This longitudinal study followed workers who were occupationally injured in 2009. Psychological symptoms and return to work were assessed at 3 and 12 months after injury. Injured workers who had completed the initial questionnaire survey at 3 or 12 months after injury were recruited. A self-administered questionnaire was mailed to the participants. For workers with high Brief Symptom Rating Scale and Post-traumatic Symptom Checklist scores, an in-depth psychiatric evaluation was performed using the Mini-international Neuropsychiatric Interview. A total of 570 workers completed the questionnaire (response rate, 28.7%). Among them, 243 (42.6%) had high psychological symptom scores and were invited for a phone interview; 135 (55.6%) completed the interview. The estimated rates of major depression and post-traumatic stress disorder (PTSD)/partial PTSD were 9.2 and 7.2%, respectively, and both these rates were higher at 6 years after injury than at 12 months after injury (2.0 and 5.1%). After adjustment for family and social factors, the risk factors for high psychological scores were length of hospitalization immediately after injury, affected physical appearance, repeated occupational injuries, unemployment, and number of quit jobs after the injury. At 6 years after occupational injury, the re-emergence of psychiatric disorders was observed. Relevant factors for poor psychological health were severity of injury and instability of work. Periodic monitoring of psychological and physical health and economic stability are warranted.

  2. Posttraumatic stress predicting depression and social support among college students: Moderating effects of race and gender.

    Science.gov (United States)

    Boyraz, Güler; Horne, Sharon G; Armstrong, Aisha P; Owens, Archandria C

    2015-05-01

    More than half of the students entering college report a history of potentially traumatic events; however, little is known about the relationship of trauma exposure and posttraumatic stress disorder (PTSD) symptomatology to college students' mental health and access to social support or whether these relationships may show variations as a function of race and gender. The purpose of this study was to explore whether the relationships between PTSD symptoms and both depression and social support were moderated by gender and race. Data were collected from 631 African American (AA) and 299 European American (EA) freshmen students attending 2 universities in the Southeast. The majority of the students (74.3% of the AA and 68.2% of the EA sample) reported lifetime exposure to at least 1 traumatic event. PTSD symptomatology was significantly and positively associated with depression symptoms for all groups (i.e., AA and EA males and females); however, the relationship between these 2 variables was strongest for EA men. Similarly, the relationship between PTSD symptoms on the avoidance cluster and social support was stronger for EA males than other groups; avoidance symptoms did not significantly predict social support for AA men.

  3. [Anxiety, Depression and Posttraumatic Stress Disorder in Refugees - A Systematic Review].

    Science.gov (United States)

    Lindert, Jutta; von Ehrenstein, Ondine S; Wehrwein, Annette; Brähler, Elmar; Schäfer, Ingo

    2017-05-03

    Anxiety, depression and posttraumatic stress disorder are the main psychopathological symptoms shown by refugees. We conducted a systematic review. First, we identified key-words for a systematic search in PUBMED. We included original articles since 2009 with 1) a non-clinical sample of refugees, 2) refugees living at maximum 5 years in the host country, 4) with the outcomes anxiety, depression, and PTSD and 5) a sample with >100 participants. Then we read titles, abstracts and fulltexts. We identified 1 877 studies. Based on this screening procedure, we included in our review 15 studies. 52% of the refugees are from Africa (Somalia, Congo, Rwanda, Liberia, Sierra-Leon and Togo), 33% from Asia (Syria, Bhutan, Vietnam, Cambodia, Iraq) and 16% are from more than one continent. In those studies n=6 769 refugees participated in the studies. The number of participants varied from n=117 to n=1,422 (Median: n=366 refugees). Prevalence rates for PTBS varied from 5-71% (mean prevalence rate: 32%) rates for depression varied from 11-54% (mean prevalence rate: 35%). Sensitivity analyses suggest that refugees, which come from countries with intense human rights violations according to the Political Terror Scale, have an increased rate of psychopathological symptoms. Heterogeneity of prevalence rate is related both 1) to methodological and 2) to difference in the refugee populations according to the human rights violations in the countries of origin of refugees. It is necessary to include further databases in a systematic review. There is an urgent need for representative studies on refugees needs for psychosocial and medical care, especially for those refugees coming from countries with intense human rights violations. Psychosocial and medical services for these refugees are urgently needed to enhance and enable a perspective in the host country Germany. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Symptoms of Posttraumatic Stress, Depression and Body Image Distress in Female Victims of Physical and Sexual Assault: Exploring Integrated Responses

    OpenAIRE

    Weaver, Terri L.; Griffin, Michael G.; Mitchell, Elisha R.

    2014-01-01

    While body image concerns and interpersonal violence exposure are significant issues for women, their interrelationship has been rarely explored. We examined the associations between severity of acute injuries, symptoms of posttraumatic stress disorder (PTSD), depression and body image distress within a sample of predominantly African-American victims of interpersonal violence (N = 73). Severity of body image distress was significantly associated with each outcome. Moreover, body image distre...

  5. The Relationship between Posttraumatic Stress Disorder Checklist (PCL) Symptom Endorsement and Self-Reported Symptoms of Anxiety and Depression

    Science.gov (United States)

    2012-01-01

    syndromal ” presentation of PTSD where criterion B was met and either criterion C or D but not both. Generalized Anxiety Disorder (GAD) symptoms were...disorders. Patient health questionnaire. JAMA 282: 1737-1744. 21. Sheehan DV, Harnett- Sheehan K, Raj BA (1996) The measurement of disability. Int Clin...depressive disorders. Med Care 26: 775- 789. 23. Coyne JC, Thompson R (2007) Posttraumatic stress syndromes : Useful or negative Heuristics? J Anxiety Disord

  6. Onset of Posttraumatic Stress Disorder and Major Depression Among Refugees and Voluntary Migrants to the United States

    OpenAIRE

    Rasmussen, Andrew; Crager, Mia; Baser, Ray E.; Chu, Tracy; Gany, Francesca

    2012-01-01

    Although refugees are generally thought to be at increased risk for posttraumatic stress disorder (PTSD) and major depressive episode (MDE), few studies have compared onset of PTSD and MDE between refugees and voluntary migrants. Given differences in migration histories, onset should differ pre- and postmigration. The National Latino and Asian American Survey (NLAAS) is a national representative, complex dataset measuring psychiatric morbidity, mental health service use, and migration history...

  7. Impact of coping styles on post-traumatic stress disorder and depressive symptoms among pregnant women exposed to Hurricane Katrina.

    Science.gov (United States)

    Oni, Olurinde; Harville, Emily W; Xiong, Xu; Buekens, Pierre

    2012-01-01

    Experiencing natural disasters such as hurricanes is associated with post-traumatic stress disorder (PTSD) and depression. We examined the role played by perceived stress and coping styles in explaining and modifying this association among pregnant women exposed to Hurricane Katrina. The study comprised 192 women (133 from New Orleans and 59 from Baton Rouge) who were pregnant during Hurricane Katrina or became pregnant immediately after the hurricane. Women were interviewed regarding their hurricane experience, perceived stress, and mental health outcomes. Coping styles was assessed using the Brief COPE, PTSD symptoms using the Post-Traumatic Checklist, and depressive symptoms using the Edinburgh Depression Scale. Multivariable regression models were run to determine the effects of coping styles on mental health and the interactions among coping styles, hurricane experience, and perceived stress on mental health. Apart from the positive reframing and humor coping styles, all coping styles correlated positively with PTSD or depression (p hurricane experience. Coping styles are potential moderators of the effects of stress on mental health of pregnant women.

  8. Comparing neural correlates of REM sleep in posttraumatic stress disorder and depression: a neuroimaging study.

    Science.gov (United States)

    Ebdlahad, Sommer; Nofzinger, Eric A; James, Jeffrey A; Buysse, Daniel J; Price, Julie C; Germain, Anne

    2013-12-30

    Rapid eye movement (REM) sleep disturbances predict poor clinical outcomes in posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). In MDD, REM sleep is characterized by activation of limbic and paralimbic brain regions compared to wakefulness. The neural correlates of PTSD during REM sleep remain scarcely explored, and comparisons of PTSD and MDD have not been conducted. The present study sought to compare brain activity patterns during wakefulness and REM sleep in 13 adults with PTSD and 12 adults with MDD using [¹⁸F]-fluoro-2-deoxy-D-glucose positron emission tomography (PET). PTSD was associated with greater increase in relative regional cerebral metabolic rate of glucose (rCMRglc) in limbic and paralimbic structures in REM sleep compared to wakefulness. Post-hoc comparisons indicated that MDD was associated with greater limbic and paralimbic rCMRglc during wakefulness but not REM sleep compared to PTSD. Our findings suggest that PTSD is associated with increased REM sleep limbic and paralimbic metabolism, whereas MDD is associated with wake and REM hypermetabolism in these areas. These observations suggest that PTSD and MDD disrupt REM sleep through different neurobiological processes. Optimal sleep treatments between the two disorders may differ: REM-specific therapy may be more effective in PTSD.

  9. Symptoms of posttraumatic stress, depression, and body image distress in female victims of physical and sexual assault: exploring integrated responses.

    Science.gov (United States)

    Weaver, Terri L; Griffin, Michael G; Mitchell, Elisha R

    2014-01-01

    While body image concerns and interpersonal violence exposure are significant issues for women, their interrelationship has rarely been explored. We examined the associations between severity of acute injuries, symptoms of posttraumatic stress disorder (PTSD), depression, and body image distress within a sample of predominantly African American victims of interpersonal violence (N = 73). Severity of body image distress was significantly associated with each outcome. Moreover, body image distress was a significant, unique predictor of depression but not PTSD severity. We recommend continued exploration of body image concerns to further integrated research on violence against women.

  10. The influence of posttraumatic stress disorder, depression, and sensory processing patterns on occupational engagement: a case study.

    Science.gov (United States)

    Champagne, Tina

    2011-01-01

    The purpose of this article is to provide a brief overview of how Posttraumatic Stress Disorder (PTSD), Depression, and Sensory Processing patterns influence occupational engagement, including work performance. Interventions and outcomes of the Sensory Modulation Program and approaches from Cognitive Behavior Therapy (CBT) are reviewed through single case exploration with a 42 year-old woman in outpatient services. The marked increase in occupational engagement and improved work performance in this single case review demonstrates the need for more research on the use of the Sensory Modulation Program and approaches from CBT with populations with PTSD, Depression, and Sensory Processing disorder.

  11. Self-Rated Mental Health: Screening for Depression and Posttraumatic Stress Disorder Among Women Exposed to Perinatal Intimate Partner Violence.

    Science.gov (United States)

    Kastello, Jennifer C; Jacobsen, Kathryn H; Gaffney, Kathleen F; Kodadek, Marie P; Bullock, Linda C; Sharps, Phyllis W

    2015-11-01

    The purpose of the current study was to evaluate the validity of a single-item, self-rated mental health (SRMH) measure in the identification of women at risk for depression and posttraumatic stress disorder (PTSD). Baseline data of 239 low-income women participating in an intimate partner violence (IPV) intervention study were analyzed. PTSD was measured with the Davidson Trauma Scale. Risk for depression was determined using the Edinburgh Postnatal Depression Scale. SRMH was assessed with a single item asking participants to rate their mental health at the time of the baseline interview. Single-item measures can be an efficient way to increase the proportion of patients screened for mental health disorders. Although SRMH is not a strong indicator of PTSD, it may be useful in identifying pregnant women who are at increased risk for depression and need further comprehensive assessment in the clinical setting. Future research examining the use of SRMH among high-risk populations is needed.

  12. Prevalence and gender differences in symptomatology of posttraumatic stress disorder and depression among Iraqi Yazidis displaced into Turkey

    Directory of Open Access Journals (Sweden)

    Atilla Tekin

    2016-02-01

    Full Text Available Background: Posttraumatic stress disorder (PTSD and depression are common among populations displaced due to large-scale political conflicts and war. Objective: The aim of this study is to investigate the prevalence and gender-based differences in symptoms of PTSD and depression among Iraqi Yazidis displaced into Turkey. Method: The study was conducted on 238 individuals who were evaluated using the Structured Clinical Interview for DSM-IV (SCID-I and the Stressful Life Events Screening Questionnaire. Results: Of the participants, 42.9% met the DSM-IV diagnostic criteria for PTSD, 39.5% for major depression, and 26.4% for both disorders. More women than men suffered from PTSD and major depression. More women than men with PTSD or depression reported having experienced or witnessed the death of a spouse or child. Women with PTSD reported flashbacks, hypervigilance, and intense psychological distress due to reminders of trauma more frequently than men. Men with PTSD reported feelings of detachment or estrangement from others more frequently than women. More depressive women than men reported feelings of guilt or worthlessness. Conclusions: PTSD and major depression affected women more frequently than men. While women tended to respond to traumatic stress by undermodulation of emotions and low self-esteem, men tended to respond by overmodulation of emotions. Rather than being a derivative of sex differences, this complementary diversity in response types between genders seems to be shaped by social factors in consideration of survival under extreme threat.

  13. Psychological resilience is associated with more intact social functioning in veterans with post-traumatic stress disorder and depression.

    Science.gov (United States)

    Wingo, Aliza P; Briscione, Maria; Norrholm, Seth D; Jovanovic, Tanja; McCullough, S Ashley; Skelton, Kelly; Bradley, Bekh

    2017-03-01

    Patients with depression or post-traumatic stress disorder (PTSD), common sequelae among individuals exposed to stressful or traumatic events, often report impairment in social functioning. Resilience is a multidimensional construct that enables adaptive coping with life adversity. Relationship between resilience and social functioning among veterans with depression and PTSD is not entirely clear and is the focus of this report. Resilience was assessed in 264 veterans using the Connor-Davidson Resilience Scale, PTSD with the PTSD Symptom Scale, depression with the Beck Depression Inventory, and social functioning with the Short Form Health Survey. Higher resilience was associated with more intact social functioning after PTSD and depression severity, childhood maltreatment, physical health, gender, education, marital status, and employment were simultaneously adjusted for. Childhood maltreatment, gender, marital status, education, and employment did not predict social functioning; however, greater severity of PTSD, depression, or physical health problems was each significantly associated with more impaired social functioning. Our findings suggest that higher resilience was associated with more intact social functioning regardless of the severity of PTSD and depression. Given the importance of social functioning in depression and/or PTSD recovery, studies are needed to examine if enhancing resilience presents a complementary approach to alleviating impaired social functioning.

  14. The role of major depression in neurocognitive functioning in patients with posttraumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Mirjam J. Nijdam

    2013-04-01

    Full Text Available Background: Posttraumatic stress disorder (PTSD and major depressive disorder (MDD frequently co-occur after traumatic experiences and share neurocognitive disturbances in verbal memory and executive functioning. However, few attempts have been made to systematically assess the role of a comorbid MDD diagnosis in neuropsychological studies in PTSD. Objective: The purpose of the current study is to investigate neurocognitive deficits in PTSD patients with and without MDD. We hypothesized that PTSD patients with comorbid MDD (PTSD+MDD would have significantly lower performance on measures of verbal memory and executive functioning than PTSD patients without MDD (PTSD–MDD. Method: Participants included in this study were 140 treatment-seeking outpatients who had a diagnosis of PTSD after various single traumatic events and participated in a randomized controlled trial comparing different treatment types. Baseline neuropsychological data were compared between patients with PTSD+MDD (n=84 and patients with PTSD–MDD (n=56. Results: The PTSD+MDD patients had more severe verbal memory deficits in learning and retrieving words than patients with PTSD alone. There were no differences between the groups in recall of a coherent paragraph, recognition, shifting of attention, and cognitive interference. Conclusions: The results of this study suggest that a more impaired neurocognitive profile may be associated with the presence of comorbid MDD, with medium-sized group differences for verbal memory but not for executive functioning. From a clinical standpoint, being aware that certain verbal memory functions are more restricted in patients with comorbid PTSD and MDD may be relevant for treatment outcome of trauma-focused psychotherapy.

  15. Longitudinal Linkages between Depressive and Posttraumatic Stress Symptoms in Adolescent Survivors Following the Wenchuan Earthquake in China: A Three-Wave, Cross-Lagged Study

    Science.gov (United States)

    Ying, Liu-Hua; Wu, Xin-Chun; Lin, Chong-De

    2012-01-01

    This study aimed to determine the relationships between depressive and posttraumatic stress disorder (PTSD) symptoms in a sample of adolescent survivors following the Wenchuan earthquake in China. Two-hundred adolescent survivors were reviewed at 12, 18 and 24-months post-earthquake. Depression and PTSD were assessed by two self-report…

  16. Exposure characteristics and peri-trauma emotional reactions during the 2004 tsunami in Southeast Asia--what predicts posttraumatic stress and depressive symptoms?

    DEFF Research Database (Denmark)

    Rosendal, Susanne; Salcioglu, Ebru; Andersen, Henrik Steen

    2011-01-01

    and depression were 10.2% and 6.4%, respectively. The strongest predictors of posttraumatic stress and depressive symptoms were peri-trauma fear and dissociation. Among exposure variables, only witnessing others suffering was associated with both these disorders, whereas loss of family members and history...

  17. A follow-up study of posttraumatic stress disorder, anxiety, and depression in Australian victims of domestic violence.

    Science.gov (United States)

    Mertin, P; Mohr, P B

    2001-12-01

    Although posttraumatic stress disorder (PTSD), anxiety, and depression are acknowledged consequences of domestic violence, little information is available on the course of recovery over time and factors that may mediate positive outcome. Fifty-nine women were assessed for the presence of PTSD and levels of anxiety and depression at time of shelter residence and again one year later. Results at follow-up indicated a significant reduction in the incidence of PTSD, although a substantial number of women continued to report a range of posttrauma symptoms. There were also significant reductions in the levels of anxiety and depression over the 12-month period. Findings indicated the particular importance of safety and the presence of social support as prerequisites for recovery.

  18. Longitudinal study of posttraumatic stress disorder, depression, and changes in traumatic memories over time in Bosnian refugees.

    Science.gov (United States)

    Mollica, Richard F; Caridad, Kathleen Rey; Massagli, Michael P

    2007-07-01

    This longitudinal study examined traumatic memory consistency over a 3-year period among a sample of highly traumatized Bosnian refugees, focusing on demographic factors, types of trauma, and posttraumatic stress disorder (PTSD) and depression. In 1996 and 1999, 376 Bosnian refugees were interviewed about 54 wartime trauma and torture events, and symptoms of PTSD and depression. Reports were compared for both time periods, and changed responses were analyzed for significance. Overall, there was consistency in reporting over time; when change occurred it was in the direction of decreased reports at follow-up. This downward trend was not associated with any particular diagnosis. However, PTSD alone, without comorbid symptoms of depression, was uniquely associated with the group that exhibited an upward trend. This implies that increased reporting is related specifically to the presence of PTSD symptoms, and that PTSD may be distinctly associated with the failed extinction of traumatic memories.

  19. Depression and post-traumatic stress disorder in child victims of sexual abuse: perceived social support as a protection factor.

    Science.gov (United States)

    Aydin, Berna; Akbas, Seher; Turla, Ahmet; Dundar, Cihad

    2016-08-01

    Background Social support has been shown to play a protective role against the development of post-traumatic stress disorder (PTSD) and depression in individuals exposed to trauma. Aims The purpose of this study was to investigate the effect of perceived social support on depression and PTSD in child victims of sexual abuse and to determine the relationship between them. Method In total 182 victims of sexual abuse aged 6-18 at time of interview were assessed. Clinical interviews, the Children's Depression Inventory (CDI) and the Child Posttraumatic Stress Reaction Index (CPTS-RI) were used to assess children's psychological status, while the Perceived Social Support Scale-Revised (PSSS-R) was used to measure social support. Results Girls had significantly higher median CDI and CPTS-RI scores than boys, while no significant difference was determined between boys and girls in terms of PSSS-R scores. A statistically significant negative correlation was determined between CDI and PSSS-R scores, CPTS-RI scores and PSSS-R scores in girls, while no significant correlation was identified in male victims. Conclusions In conclusion, we think that social support networks for victims of sexual abuse need to be broadened and increased, and that importance should be attached to protective approaches in that context.

  20. Hemicrania Continua Headache in a Veteran with Posttraumatic Stress Disorder and Major Depressive Disorder without Traumatic Brain Injury.

    Science.gov (United States)

    Kohrt, Brandon A; Duncan, Erica

    2012-01-01

    Hemicrania continua is a headache characterized by chronic unremitting unilateral pain associated with ipsilateral autonomic findings. This type of headache responds to high-flow oxygen and indomethacin. This case report describes a male veteran with posttraumatic stress disorder (PTSD) and major depressive disorder who suffers from comorbid hemicrania continua. The psychiatric symptoms were recalcitrant to psychopharmacological intervention. However, when the patient's hemicrania continua was treated appropriately, the patient's psychiatric symptoms also abated. This case demonstrates the need to address physical comorbidities that may exacerbate psychiatric disorders, such as PTSD.

  1. Hemicrania Continua Headache in a Veteran with Posttraumatic Stress Disorder and Major Depressive Disorder without Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Brandon A. Kohrt

    2012-01-01

    Full Text Available Hemicrania continua is a headache characterized by chronic unremitting unilateral pain associated with ipsilateral autonomic findings. This type of headache responds to high-flow oxygen and indomethacin. This case report describes a male veteran with posttraumatic stress disorder (PTSD and major depressive disorder who suffers from comorbid hemicrania continua. The psychiatric symptoms were recalcitrant to psychopharmacological intervention. However, when the patient's hemicrania continua was treated appropriately, the patient's psychiatric symptoms also abated. This case demonstrates the need to address physical comorbidities that may exacerbate psychiatric disorders, such as PTSD.

  2. Post-disaster stressful life events and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among responders to the World Trade Center disaster.

    Science.gov (United States)

    Zvolensky, Michael J; Kotov, Roman; Schechter, Clyde B; Gonzalez, Adam; Vujanovic, Anka; Pietrzak, Robert H; Crane, Michael; Kaplan, Julia; Moline, Jacqueline; Southwick, Steven M; Feder, Adriana; Udasin, Iris; Reissman, Dori B; Luft, Benjamin J

    2015-02-01

    The current study examined contributions of post-disaster stressful life events in relation to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning among rescue, recovery, and clean-up workers who responded to the September 11, 2001 World Trade Center (WTC) terrorist attacks. Participants were 18,896 WTC responders, including 8466 police officers and 10,430 non-traditional responders (85.8% male; 86.4% Caucasian; M(age) = 39.5, SD = 8.8) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and who were reassessed, on average, 2.5 years later. Path analyses were conducted to evaluate contributions of life events to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning. These analyses were stratified by police and non-traditional responder groups and adjusted for age, sex, time from 9/11 to initial visit, WTC exposures (three WTC contextual exposures: co-worker, friend, or a relative died in the disaster; co-worker, friend, or a relative injured in the disaster; and responder was exposed to the dust cloud on 9/11), and interval from initial to first follow-up visit. In both groups, WTC-related posttraumatic stress, depressive symptoms, and overall functioning were stable over the follow-up period. WTC exposures were related to these three outcomes at the initial assessment. WTC-related posttraumatic stress, depressive symptoms, and overall functioning, at the initial assessment each predicted the occurrence of post-disaster stressful life events, as measured by Disaster Supplement of the Diagnostic Interview Schedule. Post-disaster stressful life events, in turn, were associated with subsequent mental health, indicating partial mediation of the stability of observed mental health. The present findings suggest a dynamic interplay between exposure, post-disaster stressful life events, and WTC-related posttraumatic stress

  3. Posttraumatic stress disorder, depression, and alcohol and tobacco use in public health workers after the 2004 Florida hurricanes.

    Science.gov (United States)

    Fullerton, Carol S; McKibben, Jodi B A; Reissman, Dori B; Scharf, Ted; Kowalski-Trakofler, Kathleen M; Shultz, James M; Ursano, Robert J

    2013-02-01

    We examined the relationship of probable posttraumatic stress disorder (PTSD), probable depression, and increased alcohol and/or tobacco use to disaster exposure and work demand in Florida Department of Health workers after the 2004 hurricanes. Participants (N = 2249) completed electronic questionnaires assessing PTSD, depression, alcohol and tobacco use, hurricane exposure, and work demand. Total mental and behavioral health burden (probable PTSD, probable depression, increased alcohol and/or tobacco use) was 11%. More than 4% had probable PTSD, and 3.8% had probable depression. Among those with probable PTSD, 29.2% had increased alcohol use, and 50% had increased tobacco use. Among those with probable depression, 34% indicated increased alcohol use and 55.6% increased tobacco use. Workers with greater exposure were more likely to have probable PTSD and probable depression (ORs = 3.3 and 3.06, respectively). After adjusting for demographics and work demand, those with high exposure were more likely to have probable PTSD and probable depression (ORs = 3.21 and 3.13). Those with high exposure had increased alcohol and tobacco use (ORs = 3.01 and 3.40), and those with high work demand indicated increased alcohol and tobacco use (ORs = 1.98 and 2.10). High exposure and work demand predicted increased alcohol and tobacco use, after adjusting for demographics, work demand, and exposure. Work-related disaster mental and behavioral health burden indicate the need for additional mental health interventions in the public health disaster workforce.

  4. Intimate Partner Violence, Physical Health, Posttraumatic Stress Disorder, Depression, and Quality of Life in Latinas

    Directory of Open Access Journals (Sweden)

    Kelly, Ursula

    2010-08-01

    Full Text Available Objectives: The purposes of this exploratory study were to a describe physical health symptoms and diagnoses in abused immigrant Latinas, b explore the relationships between the women’s physical health and their experiences of intimate partner violence, their history of childhood trauma, and their immigration status, and c explore the correlations between their physical health, health related quality of life (HRQOL, and mental health, specifically symptoms of post-traumatic stress disorder (PTSD and major depressive disorder (MDD.Methods: The convenience sample (n=33 for this cross-sectional descriptive study consisted of Latino women who were receiving emergency shelter and community-based services at a domestic violence services agency in the northeastern U.S. Pearson product-moment correlation coefficients were used to analyze the relationships between physical health variables and IPV type and severity, childhood and adulthood sexual abuse, and HRQOL.Results: All of the women experienced threatened abuse. More than two-thirds of the women experienced moderate to severe psychological abuse, moderate to severe physical abuse, and/or sexual abuse. Twenty women experienced all three types. Women endorsed one or more items in neuromuscular (69.7%, gastrointestinal (63.6%, and genitourinary/gynecologic (45.5% groupings. Pain was the most reported symptom: bodily pain in previous month (60%, repeated neck or back pain (54.5%, severe/frequent headaches (54.5%, and pelvic pain (21.2%. Eighty-one percent of women endorsed at least one pain item (mean=2.56 and the same number reported difficulty falling asleep or staying asleep. Pain and sleeping difficulty, the two most frequently reported symptoms, were consistently and highly correlated with PTSD and MDD diagnoses and symptom severity and HRQOL. Childhood sexual abuse was significantly correlated with total pain symptoms (r=0.606; p=0.000 and difficulty sleeping (from the PTSD scale (r=0.349; p=0

  5. Psychological responses after a major fatal earthquake: The effect of preitraumatic dissociation and posttraumatic stress symptoms on anxiety and depression.

    OpenAIRE

    Duncan, Esma; Dorahy, Martin J; Hanna, Donncha; Bagshaw, Sue; Blampied , Neville

    2013-01-01

    Following trauma, most people with initial symptoms of stress recover, but it is important to identify those at risk for continuing difficulties so resources are allocated appropriately. There has been limited investigation of predictors of posttraumatic stress disorder following natural disasters. This study assessed psychological difficulties experienced in 101 adult treatment seekers following exposure to a significant earthquake. Peritraumatic dissociation, posttraumatic stress symptoms, ...

  6. Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster: a study of comorbidity

    Directory of Open Access Journals (Sweden)

    Bastia Binaya

    2006-07-01

    Full Text Available Abstract Background Information on mental health sequel in adolescents following natural disasters from developing countries is scant. Method Around one year after a super-cyclone, proportion of adolescents exhibiting post-traumatic psychiatric symptoms, prevalence of post-traumatic stress disorder (PTSD, major depression and generalized anxiety disorder, comorbidity and impairment of performance in school were studied in Orissa, India. Mini International Neuropsychiatric Interview for children and adolescents was used for evaluation and diagnosis. The criteria for diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders – IV. Results Post-disaster psychiatric presentation in adolescents was a conglomeration of PTSD, depression and anxiety symptoms. The prevalences of PTSD, major depressive disorder and generalised anxiety disorder were 26.9%, 17.6% and 12.0% respectively. Proportion of adolescents with any diagnosis was 37.9%. Comorbidity was found in 39.0% of adolescents with a psychiatric diagnosis. Adolescents from middle socioeconomic status were more affected. There were gender differences in the presentation of the symptoms rather than on the prevalence of diagnoses. Prolonged periods of helplessness and lack of adequate post-disaster psychological support were perceived as probable influencing factors, as well as the severity of the disaster. Conclusion The findings of the study highlight the continuing need for identification and intervention for post-disaster psychiatric morbidities in adolescent victims in developing countries.

  7. Beyond fear: the role of peritraumatic responses in posttraumatic stress and depressive symptoms among female crime victims.

    Science.gov (United States)

    Rizvi, Shireen L; Kaysen, Debra; Gutner, Cassidy A; Griffin, Michael G; Resick, Patricia A

    2008-06-01

    This study examines peritraumatic (and posttrauma) responses in a sample of female crime victims who had been sexually or physically assaulted within the previous 2 months. Women were interviewed about their emotional and behavioral responses during the trauma and assessed for posttraumatic stress disorder and depression symptomatology. Results indicate that women experience a wide range of behavioral and emotional responses during a traumatic event and that these responses have implications for posttrauma adjustment. Women who experienced behaviors typical of a freeze response are more likely to have a greater degree of symptomatology after the assault. Peritraumatic emotions, other than fear, such as sadness, humiliation, and anger, also appear to be related to posttrauma depression symptoms. These findings highlight the necessity of exploring the full range of possible reactions during a trauma.

  8. Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike

    Science.gov (United States)

    Pietrzak, Robert H.; Southwick, Steven M.; Tracy, Melissa; Galea, Sandro; Norris, Fran H.

    2012-01-01

    Objective To examine the prevalence and correlates of disaster-related posttraumatic stress disorder (PTSD), depression, and needs for psychological care in older persons affected by Hurricane Ike. Method A total of 193 adults age 60 or older who resided in the Galveston Bay area were interviewed 2–5 months following Hurricane Ike. Pre-, peri-, and post-disaster variables hypothesized to be related to PTSD and depressive symptoms, and perceived needs for psychological care were assessed. Results Weighted prevalences of past-month Ike-related PTSD and depression were 7.6% and 8.6%, respectively. Risk factors for Ike-related PTSD symptoms were predominantly peri-disaster in nature, with greater hurricane exposure, and peri-event dissociative and autonomic activation symptoms associated positively with these symptoms. Risk factors for depressive symptoms were predominantly pre-disaster in nature, with being married/living with partner associated negatively, and prior disaster exposure and pre-disaster PTSD or depression associated positively with these symptoms. 27.2% of the sample endorsed at least one of the perceived needs for psychological care assessed. A history of PTSD or depression, greater peri-event autonomic activation, and Ike-related PTSD and depressive symptoms were associated with greater need for psychological care. Limitations This study is limited by its cross-sectional design and employment of psychiatric screening instruments. Conclusions A substantial proportion of older adults may have PTSD and depression, as well as perceived needs for psychological care, after a disaster. Assessment of disaster exposures, and peri-event dissociative and autonomic symptoms may help identify older adults at risk for disaster-related psychopathology. Older adults with a history of PTSD or depression, and greater peri-event autonomic activation and PTSD symptoms may be more likely to have needs for psychological care. PMID:22285792

  9. Unique and related predictors of major depressive disorder, posttraumatic stress disorder, and their comorbidity after Hurricane Katrina.

    Science.gov (United States)

    Nillni, Yael I; Nosen, Elizabeth; Williams, Patrick A; Tracy, Melissa; Coffey, Scott F; Galea, Sandro

    2013-10-01

    The current study examined demographic and psychosocial factors that predict major depressive disorder (MDD) and comorbid MDD/posttraumatic stress disorder (MDD/PTSD) diagnostic status after Hurricane Katrina, one of the deadliest and costliest hurricanes in the history of the United States. This study expanded on the findings published in the article by Galea, Tracy, Norris, and Coffey (J Trauma Stress 21:357-368, 2008), which examined the same predictors for PTSD, to better understand related and unique predictors of MDD, PTSD, and MDD/PTSD comorbidity. A total of 810 individuals representative of adult residents living in the 23 southernmost counties of Mississippi before Hurricane Katrina were interviewed. Ongoing hurricane-related stressors, low social support, and hurricane-related financial loss were common predictors of MDD, PTSD, and MDD/PTSD, whereas educational and marital status emerged as unique predictors of MDD. Implications for postdisaster relief efforts that address the risk for both MDD and PTSD are discussed.

  10. Posttraumatic stress disorder, anxiety and depression following pregnancies conceived through fertility treatments : the effects of medically assisted conception on postpartum well-being

    NARCIS (Netherlands)

    Warmelink, J Catja; Stramrood, Claire A I; Paarlberg, K Marieke; Haisma, Hinke H; Vingerhoets, A J J M; Schultz, Willibrord C M Weijmar; van Pampus, Maria G

    2012-01-01

    OBJECTIVE: To compare the postpartum prevalence of Posttraumatic Stress Disorder (PTSD), anxiety and depression in women who conceived via medically assisted conception (MAC) and women who conceived naturally. STUDY DESIGN: All women (n = 907) who delivered under supervision of four independent midw

  11. Do Cognitive Models Help in Predicting the Severity of Posttraumatic Stress Disorder, Phobia, and Depression after Motor Vehicle Accidents? A Prospective Longitudinal Study

    Science.gov (United States)

    Ehring, Thomas; Ehlers, Anke; Glucksman, Edward

    2008-01-01

    The study investigated the power of theoretically derived cognitive variables to predict posttraumatic stress disorder (PTSD), travel phobia, and depression following injury in a motor vehicle accident (MVA). MVA survivors (N = 147) were assessed at the emergency department on the day of their accident and 2 weeks, 1 month, 3 months, and 6 months…

  12. Sequential Temporal Dependencies in Associations between Symptoms of Depression and Posttraumatic Stress Disorder: An Application of Bivariate Latent Difference Score Structural Equation Modeling

    Science.gov (United States)

    King, Daniel W.; King, Lynda A.; McArdle, John J.; Shalev, Arieh Y.; Doron-LaMarca, Susan

    2009-01-01

    Depression and posttraumatic stress disorder (PTSD) are highly comorbid conditions that may arise following exposure to psychological trauma. This study examined their temporal sequencing and mutual influence using bivariate latent difference score structural equation modeling. Longitudinal data from 182 emergency room patients revealed level of…

  13. Co-occurrence of major depressive episode and posttraumatic stress disorder among survivors of war: how is it different from either condition alone?

    NARCIS (Netherlands)

    Morina, N.; Ajdukovic, D.; Bogic, M.; Franciskovic, T.; Kucukalic, A.; Lecic-Tosevski, D.; Morina, L.; Popovski, M.; Priebe, S.

    2013-01-01

    OBJECTIVE: Major depressive episode (MDE) and posttraumatic stress disorder (PTSD) have been shown to be the most common mental disorders following traumatic war experiences and have been found to frequently co-occur. This study, designed as a randomized cross-sectional interview survey, aimed to id

  14. Concurrent and prospective associations of habitual overgeneral memory and prospection with symptoms of depression, general anxiety, obsessive compulsiveness, and post-traumatic stress

    NARCIS (Netherlands)

    Boelen, Paul A.; Huntjens, Rafaele J. C.; van den Hout, Marcel A.

    2014-01-01

    Reduced memory specificity is associated with depression, post-traumatic stress disorder (PTSD), and some other forms of psychopathology. Reduced memory specificity is also associated with reduced specificity of envisioned future events. Research in this area has mostly relied on cue-word methods th

  15. Posttraumatic stress disorder, anxiety and depression following pregnancies conceived through fertility treatments : the effects of medically assisted conception on postpartum well-being

    NARCIS (Netherlands)

    Warmelink, J Catja; Stramrood, Claire A I; Paarlberg, K Marieke; Haisma, Hinke H; Vingerhoets, A J J M; Schultz, Willibrord C M Weijmar; van Pampus, Maria G

    2012-01-01

    OBJECTIVE: To compare the postpartum prevalence of Posttraumatic Stress Disorder (PTSD), anxiety and depression in women who conceived via medically assisted conception (MAC) and women who conceived naturally. STUDY DESIGN: All women (n = 907) who delivered under supervision of four independent midw

  16. Measuring the Quality of Care for Psychological Health Conditions in the Military Health System: Candidate Quality Measures for Posttraumatic Stress Disorder and Major Depressive Disorder

    Science.gov (United States)

    2015-01-01

    and Statistical Manual of Mental Disorders, 4th ed., Axis I Disorders SDS Sheehan Disability Scale SI suicide ideation SIT Stress Inoculation Training...depression, behavioral health, mental health, MDD, PTSD, suicide , post-traumatic stress disorder, post- traumatic stress disorder, trauma, traumatic...gender, family history of suicide , same-sex orientation) and modifiable risk factors (e.g., unstable housing, financial problems, psychiatric disorders

  17. Hurricane Katrina experience and the risk of post-traumatic stress disorder and depression among pregnant women.

    Science.gov (United States)

    Xiong, Xu; Harville, Emily W; Mattison, Donald R; Elkind-Hirsch, Karen; Pridjian, Gabriella; Buekens, Pierre

    2010-01-01

    Little is known about the effects of disaster exposure and intensity on the development of mental disorders among pregnant women. The aim of this study was to examine the effect of exposure to Hurricane Katrina on mental health in pregnant women. Prospective cohort epidemiological study. Tertiary hospitals in New Orleans and Baton Rouge, U.S.A. Women who were pregnant during Hurricane Katrina or became pregnant immediately after the hurricane. Post-traumatic stress disorder (PTSD) and depression. The frequency of PTSD was higher in women with high hurricane exposure (13.8 percent) than women without high hurricane exposure (1.3 percent), with an adjusted odds ratio (aOR) of 16.8 (95% confidence interval: 2.6-106.6) after adjustment for maternal race, age, education, smoking and alcohol use, family income, parity, and other confounders. The frequency of depression was higher in women with high hurricane exposure (32.3 percent) than women without high hurricane exposure (12.3 percent), with an aOR of 3.3 (1.6-7.1). Moreover, the risk of PTSD and depression increased with an increasing number of severe experiences of the hurricane. Pregnant women who had severe hurricane experiences were at a significantly increased risk for PTSD and depression. This information should be useful for screening pregnant women who are at higher risk of developing mental disorders after a disaster.

  18. Distinctiveness of symptoms of prolonged grief, depression, and post-traumatic stress in bereaved children and adolescents.

    Science.gov (United States)

    Spuij, Mariken; Reitz, Ellen; Prinzie, Peter; Stikkelbroek, Yvonne; de Roos, Carlijn; Boelen, Paul A

    2012-12-01

    Studies among adults have shown that symptoms of prolonged grief disorder (PGD) are distinct from those of bereavement-related depression and post-traumatic stress-disorder (PTSD). This study was an attempt to replicate this finding in two distinct samples of bereaved children (N = 197; aged 8-12 years) and adolescents (N = 135; 13-18 years), confronted with the death of a parent, sibling or other close relative. Using confirmatory factor analyses, we compared the fit of a one-factor model with the fit of a three-factor model in which symptoms formed three distinct, correlated factors. In both samples, findings showed that the model in which symptoms of PGD, depression, and PTSD loaded on separate factors was superior to a one-factor model and displayed excellent model fit. Summed scores on the PGD, depression, and PTSD items were significantly associated with functional impairment, attesting to the concurrent validity of the PGD, depression, and PTSD factors. The current findings complement prior evidence from adult samples that PGD is a distinct syndrome and suggest that PGD symptoms should be addressed in the assessment and treatment of bereaved children and adolescent seeking help following their loss.

  19. Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis.

    Science.gov (United States)

    de Boer, Jacoba; Lok, Anja; Van't Verlaat, Ellen; Duivenvoorden, Hugo J; Bakker, Arnold B; Smit, Bert J

    2011-07-01

    This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals

  20. Posttraumatic Stress Disorder

    Science.gov (United States)

    ... Child What Kids Say About: Handling Stress Anxiety, Fears, and Phobias Community Service: A Family's Guide to Getting Involved ... Date Rape If Your Child Is Raped Anxiety, Fears, and Phobias Childhood Stress About Teen Suicide Sadness and Depression ...

  1. A Systematic Review of Post-traumatic Stress Disorder and Depression Amongst Iraqi Refugees Located in Western Countries.

    Science.gov (United States)

    Slewa-Younan, Shameran; Uribe Guajardo, Maria Gabriela; Heriseanu, Andreea; Hasan, Tasnim

    2015-08-01

    A systematic review of literature reporting prevalence rates of posttraumatic stress disorder (PTSD) and depression amongst community samples of resettled Iraqi refugees was undertaken. A search of the electronic databases of Medline, PsychINFO, CINAHL, PILOTS, Scopus, and Cochrane, up to November 2013 was conducted. Following the application of the inclusion and exclusion criteria, eight empirical papers were included in the review and analysis. Specifically, six studies reported on PTSD prevalence (total n = 1,912), which ranged from 8 to 37.2 % and seven studies reported on rates of depression (total n = 1,647) noted to be 28.3 to 75 %. The overall interobserver agreement for the methodological quality assessment was good to excellent with a Kappa coefficient of 0.64. Iraqi refugees continue to represent one of the largest groups being resettled worldwide. This systematic review indicates that prevalence of PTSD and depression is high and should be taken into consideration when developing mental health early intervention and treatment services.

  2. Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda

    Directory of Open Access Journals (Sweden)

    Oyok Thomas

    2008-05-01

    Full Text Available Abstract Background The 20 year war in northern Uganda between the Lord's Resistance Army and the Ugandan government has resulted in the displacement of up to 2 million people within Uganda. The purpose of the study was to measure rates of post-traumatic stress disorder (PTSD and depression amongst these internally displaced persons (IDPs, and investigate associated demographic and trauma exposure risk factors. Methods A cross-sectional multi-staged, random cluster survey with 1210 adult IDPs was conducted in November 2006 in Gulu and Amuru districts of northern Uganda. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version, and levels of depression were measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association of demographic and trauma exposure variables on the outcomes of PTSD and depression. Results Over half (54% of the respondents met symptom criteria for PTSD, and over two thirds (67% of respondents met symptom criteria for depression. Over half (58% of respondents had experienced 8 or more of the 16 trauma events covered in the questionnaire. Factors strongly linked with PTSD and depression included gender, marital status, distance of displacement, experiencing ill health without medical care, experiencing rape or sexual abuse, experiencing lack of food or water, and experiencing higher rates of trauma exposure. Conclusion This study provides evidence of exposure to traumatic events and deprivation of essential goods and services suffered by IDPs, and the resultant effect this has upon their mental health. Protection and social and psychological assistance are urgently required to help IDPs in northern Uganda re-build their lives.

  3. Quality of Life and Functioning in Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder After Treatment With Citalopram Monotherapy.

    Science.gov (United States)

    Steiner, Alexander J; Boulos, Nathalie; Mirocha, James; Wright, Stephanie M; Collison, Katherine L; IsHak, Waguih W

    Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) often have high comorbidity, consequently influencing patient-reported outcomes of depressive symptom severity, quality of life (QOL), and functioning. We hypothesized that the combined effects of concurrent PTSD and MDD would result in worse treatment outcomes, whereas individuals who achieved MDD remission would have better treatment outcomes. We analyzed 2280 adult participants who received level 1 treatment (citalopram monotherapy) in the Sequenced Treatment Alternatives to Relieve Depression study, including 2158 participants with MDD without comorbid PTSD and 122 participants with MDD with comorbid PTSD (MDD + PTSD). Post hoc analysis examined the proportion of participants whose scores were within normal or severely impaired for functioning and QOL. Remission status at exit from MDD was also determined. At entry, participants with MDD + PTSD experienced significantly worse QOL, functioning, and depressive symptom severity compared with participants with MDD without comorbid PTSD. Although both groups had significant improvements in functioning and QOL posttreatment, the participants with MDD + PTSD were less likely to achieve remission from MDD. Findings suggested that participants with MDD + PTSD are at a greater risk for severe impairment across all domains and less likely to achieve remission from MDD after treatment with citalopram monotherapy. As such, the use of patient-reported measures of QOL and functioning may inform practicing clinicians' and clinical trial researchers' abilities to develop appropriate interventions and monitor treatment efficacy. More importantly, we encourage clinicians and health care providers to routinely screen for PTSD in patients with MDD because this at-risk group requires tailored and specific pharmacotherapy and psychotherapy interventions beyond traditionally standard treatments for depression.

  4. Posttraumatic Stress Disorder

    Science.gov (United States)

    ... the lights on or take a favorite stuffed animal to bed, it might help them get through ... Anxiety, Fears, and Phobias Childhood Stress About Teen Suicide Sadness and Depression Obsessive-Compulsive Disorder Phobias Five ...

  5. Utilization of Professional Mental Health Services Related to Population-Level Screening for Anxiety, Depression, and Post-traumatic Stress Disorder Among Public High School Students.

    Science.gov (United States)

    Prochaska, John D; Le, Vi Donna; Baillargeon, Jacques; Temple, Jeff R

    2016-08-01

    This study examines results from three mental health screening measures in a cohort of adolescent public school students in seven public schools in Southeast Texas affiliated with the Dating it Safe study. We estimated the odds of receiving professional mental health treatment in the previous year given results from different mental health screening batteries: the CES-D 10 battery for depression screening, the Screen for Child Anxiety Related Disorders, and the Primary Care Posttraumatic Stress Disorder screen. Overall, students with higher scores on screening instruments for depression, posttraumatic stress disorder, and combinations of screening instruments were more likely to have sought past-year professional mental health treatment than non-symptomatic youth. However, the proportion of students screening positive and receiving professional treatment was low, ranging from 11 to 16 %. This study emphasizes the need for broader evaluation of population-based mental health screening among adolescents.

  6. Depressive symptoms and posttraumatic stress disorder as determinants of preference weights for attributes of obstetric care among Ethiopian women.

    Directory of Open Access Journals (Sweden)

    Magdalena M Paczkowski

    Full Text Available BACKGROUND: Mental health, specifically mood/anxiety disorders, may be associated with value for health care attributes, but the association remains unclear. Examining the relation between mental health and attributes in a context where quality of care is low and exposure to suboptimal health conditions is increased, such as in Sub Saharan Africa (SSA, may elucidate the association. METHODOLOGY/PRINCIPAL FINDINGS: We assessed whether preference weights for obstetric care attributes varied by mental health among 1006 women from Jimma Zone, Ethiopia, using estimates obtained through a discrete choice experiment (DCE, a method used to elicit preferences. Facilities were described by several attributes including provider attitude and performance and drug/equipment availability. Mental health measures included depressive symptoms and posttraumatic stress disorder (PTSD. We used Bayesian models to estimate preference weights for attributes and linear models to investigate whether these weights were associated with mental health. We found that women with high depressive symptoms valued a positive provider attitude [β = -0.43 (95% CI: -0.66, -0.21] and drug/equipment availability [β = -0.43 (95% CI: -0.78, -0.07] less compared to women without high depressive symptoms. Similar results were obtained for PTSD. Upon adjusting for both conditions, value for drug/equipment availability was lower only among women with both conditions [β = -0.89 (95% CI -1.4, -0.42]. CONCLUSIONS/SIGNIFICANCE: We found that women with psychopathology had lower preference weights for positive provider attitude and drug/equipment availability. Further work investigating why value for obstetric care attributes might vary by psychopathology in SSA is needed.

  7. Child abuse in the context of intimate partner violence against women: the impact of women's depressive and posttraumatic stress symptoms on maternal behavior.

    Science.gov (United States)

    Boeckel, Mariana G; Blasco-Ros, Concepción; Grassi-Oliveira, Rodrigo; Martínez, Manuela

    2014-05-01

    Intimate male partner violence against women has been recognized as an important public health problem, with a high impact on women's mental health, including depressive and posttraumatic stress disorder (PTSD) symptoms. However, fathers who have been involved in intimate partner violence (IPV) have an increased probability of being violent toward their children. The aim of this study was to assess the relation between the mental health status of abused women, their partner's violence toward the children, and their maternal behavior.

  8. Distress of Routine Activities and Perceived Safety Associated with Post-Traumatic Stress, Depression, and Alcohol Use: 2002 Washington, DC, Sniper Attacks.

    Science.gov (United States)

    Fullerton, Carol S; Herberman Mash, Holly B; Benevides, K Nikki; Morganstein, Joshua C; Ursano, Robert J

    2015-10-01

    For over 3 weeks in October 2002, a series of sniper attacks in the Washington, DC, area left 10 people dead and 3 wounded. This study examined the relationship of distress associated with routine activities and perceived safety to psychological and behavioral responses. Participants were 1238 residents of the Washington, DC, metropolitan area (aged 18 to 90 years, mean=41.7 years) who completed an Internet survey including the Impact of Event Scale-Revised, Patient Health Questionnaire-9, and items pertaining to distress related to routine activities, perceived safety, and alcohol use. Data were collected at one time point approximately 3 weeks after the first sniper shooting and before apprehension of the suspects. Relationships of distress and perceived safety to post-traumatic stress, depressive symptoms, and increased alcohol use were examined by using linear and logistic regression analyses. Approximately 8% of the participants met the symptom criteria for probable post-traumatic stress disorder, 22% reported mild to severe depression, and 4% reported increased alcohol use during the attacks. Distress related to routine activities and perceived safety were associated with increased post-traumatic stress and depressive symptoms and alcohol use. Distress and perceived safety are associated with specific routine activities and both contribute to psychological and behavioral responses during a terrorist attack. These findings have implications for targeted information dissemination and risk communication by community leaders.

  9. Onset of posttraumatic stress disorder and major depression among refugees and voluntary migrants to the United States.

    Science.gov (United States)

    Rasmussen, Andrew; Crager, Mia; Baser, Ray E; Chu, Tracy; Gany, Francesca

    2012-12-01

    Although refugees are generally thought to be at increased risk for posttraumatic stress disorder (PTSD) and major depressive episode (MDE), few studies have compared onset of PTSD and MDE between refugees and voluntary migrants. Given differences in migration histories, onset should differ pre- and postmigration. The National Latino and Asian American Survey (NLAAS) is a national representative, complex dataset measuring psychiatric morbidity, mental health service use, and migration history among Latino and Asian immigrants to the United States. Of the 3,260 foreign-born participants, 660 were refugees (a weighted proportion of 9.52%). Refugees were more likely to report a history of war-related trauma, but reports of other traumatic events were similar. Premigration onset of PTSD was statistically higher for refugees than voluntary migrants, odds ratio (OR) = 4.86, 95% confidence interval (CI) [2.01, 11.76], where postmigration onset for PTSD was not, OR = 0.61, 95% CI [0.29, 1.28]; a similar pattern was found for MDE, OR = 1.98, 95% CI [1.11, 3.51]; and OR = 1.02, 95% CI [0.65, 1.62], respectively. Although refugees arrive in host countries with more pressing psychiatric needs, onset is comparable over time, suggesting that postmigration refugees and voluntary migrants may be best served by similar programs.

  10. Relations among Posttraumatic Stress Disorder, Comorbid Major Depression, and HPA Function: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Morris, Matthew C.; Compas, Bruce E.; Garber, Judy

    2012-01-01

    Exposure to traumatic stress is associated with increased risk for posttraumatic stress disorder (PTSD) and alterations of hypothalamic-pituitary-adrenocortical (HPA) function. Research linking traumatic stress with HPA function in PTSD has been inconsistent, however, in part due to (a) the inclusion of trauma-exposed individuals without PTSD (TE) in control groups and (b) a failure to consider comorbid major depressive disorder (MDD) and moderating variables. This meta-analysis of 47 studies (123 effect sizes, N=6,008 individuals) revealed that daily cortisol output was lower for PTSD (d=−.36, SE=.15, p=.008) and PTSD+MDD (d=−.65, SE=.25, p=.008) groups relative to no trauma controls (NTC); TE and NTC groups did not differ significantly from each other. Afternoon/evening cortisol was lower in TE (d=−.25, SE=.09, p=.007) and PTSD (d=−.27, SE=.12, p=.021) groups and higher in PTSD+MDD groups (d=.49, SE=.24, p=.041) relative to NTC. Post-DST cortisol levels were lower in PTSD (d=−.40, SE=.12, p<.001), PTSD+MDD (d=−.65, SE=.14, p<.001), and TE groups (d=−.53, SE=.14, p<.001) relative to NTC. HPA effect sizes were moderated by age, sex, time since index event, and developmental timing of trauma exposure. These findings suggest that enhanced HPA feedback function may be a marker of trauma-exposure rather than a specific mechanism of vulnerability for PTSD, whereas lower daily cortisol output may be associated with PTSD in particular. PMID:22459791

  11. Attachment typologies and posttraumatic stress disorder (PTSD, depression and anxiety: a latent profile analysis approach

    Directory of Open Access Journals (Sweden)

    Cherie Armour

    2011-12-01

    Full Text Available Bartholomew (1990 proposed a four category adult attachment model based on Bowlby's (1973 proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS. In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status. The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990. Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma. A large sample of Danish trauma victims (N=1577 participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology. The three class solution was considered optimal. Class one was termed Fearful (18.6%, Class two Preoccupied (34.5%, and Class three Secure (46.9%. The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes. The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display lower levels of psychopathology post

  12. Attachment typologies and posttraumatic stress disorder (PTSD), depression and anxiety: a latent profile analysis approach

    Science.gov (United States)

    Armour, Cherie; Elklit, Ask; Shevlin, Mark

    2011-01-01

    Background Bartholomew (1990) proposed a four category adult attachment model based on Bowlby's (1973) proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS). In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status. Objective The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990). Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma. Method A large sample of Danish trauma victims (N=1577) participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology. Results The three class solution was considered optimal. Class one was termed Fearful (18.6%), Class two Preoccupied (34.5%), and Class three Secure (46.9%). The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes. Conclusions The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display

  13. Patterns of DSM-5 posttraumatic stress disorder and depression symptoms in an epidemiological sample of Chinese earthquake survivors: A latent profile analysis.

    Science.gov (United States)

    Cao, Xing; Wang, Li; Cao, Chengqi; Zhang, Jianxin; Liu, Ping; Zhang, Biao; Wu, Qi; Zhang, Hong; Zhao, Zhihong; Fan, Gaolin; Elhai, Jon D

    2015-11-01

    Posttraumatic stress disorder (PTSD) and depression are highly comorbid in association with serious clinical consequences. Nevertheless, to date, no study using latent class or latent profile analysis (LCA/LPA) has examined patterns of co-occurring PTSD and depression symptoms among natural disaster survivors, nor has the distinctiveness of DSM-5 PTSD and depression symptoms been clarified in the aftermath of trauma. This study was primarily aimed at filling these gaps. LPA was used to examine self-reported PTSD and depression symptoms in an epidemiological sample of 1196 Chinese earthquake survivors. A 4-class solution characterized by low symptoms (53.9%), predominantly depression (18.2%), predominantly PTSD (18.9%) and combined PTSD-depression (9.0%) patterns fit the data best. Demographic characteristics and earthquake-related exposures were specifically or consistently associated with the non-parallel profiles varying in physical health impairment. A sample exposed to specific traumatic events was assessed by self-report measures. The distinctiveness of DSM-5 PTSD and depression symptoms following an earthquake suggests that PTSD and depression may be independent sequelae of psychological trauma rather than a manifestation of a single form of psychopathology. The current findings support the distinction between PTSD and depression constructs, and highlight the need for identifications of natural disaster survivors at high risk for PTSD and/or depression, and interventions individually tailored to one's symptom presentations. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Psychotic depression, posttraumatic stress disorder, and engagement in cognitive-behavioral therapy within an outpatient sample of adults with serious mental illness.

    Science.gov (United States)

    Gottlieb, Jennifer D; Mueser, Kim T; Rosenberg, Stanley D; Xie, Haiyi; Wolfe, Rosemarie S

    2011-01-01

    Depression with psychotic features afflicts a substantial number of people and has been characterized by significantly greater impairment, higher levels of dysfunctional beliefs, and poorer response to psychopharmacologic and psychosocial interventions than nonpsychotic depression. Those with psychotic depression also experience a host of co-occurring disorders, including posttraumatic stress disorder (PTSD), which is not surprising given the established relationships between trauma exposure and increased rates of psychosis and between PTSD and major depression. To date, there has been very limited research on the psychosocial treatment of psychotic depression; and even less is known about those who also suffer from PTSD. The purpose of this study was to better understand the rates and clinical correlates of psychotic depression in those with PTSD. Clinical and symptom characteristics of 20 individuals with psychotic depression and 46 with nonpsychotic depression, all with PTSD, were compared before receiving cognitive-behavioral therapy for PTSD treatment or treatment as usual. Patients with psychotic depression exhibited significantly higher levels of depression and anxiety, a weaker perceived therapeutic alliance with their case managers, more exposure to traumatic events, and more negative beliefs related to their traumatic experiences, as well as increased levels of maladaptive cognitions about themselves and the world, compared with participants without psychosis. Implications for cognitive-behavioral therapy treatment aimed at dysfunctional thinking for this population are discussed. © 2011 Elsevier Inc. All rights reserved.

  15. Depression, Somatization, and Posttraumatic Stress Disorder in Children Born of Occupation After World War II in Comparison With a General Population.

    Science.gov (United States)

    Kaiser, Marie; Kuwert, Philipp; Braehler, Elmar; Glaesmer, Heide

    2015-10-01

    At the end of World War II and during the first decade after the war, roughly 200,000 children were fathered in intimate contacts between German women and foreign soldiers. The experiences of these German occupation children (GOC) have been so far described in case reports and from historical perspective only. Research on psychosocial consequences of growing up as a GOC has been missing so far. This study examined traumatic experiences, posttraumatic stress disorder, somatization, and depression in GOC (N = 146) using self-report instruments: Posttraumatic Diagnostic Scale and Patient Health Questionnaire. Findings have then been compared with a representative birth cohort-matched sample from the German general population (N = 977). German occupation children showed significantly higher prevalence rates of most traumatic experiences, higher point prevalence rates of full and partial posttraumatic stress disorder, depression, and somatization than the control group. In summary, GOC often grew up under difficult conditions (e.g., poverty, single mothers, and stigmatization). Even decades later, they showed higher rates of different mental disorders and higher comorbidity. These findings underline the complex and long-term impact of their burdened social, financial, and familial conditions. The results underpin the importance of conceptualizing occupation children as a vulnerable group in postconflict settings.

  16. Reconsidering Post-Traumatic Stress

    Science.gov (United States)

    Berman, Dene S.; Davis-Berman, Jennifer

    2005-01-01

    This article serves to challenge the prevailing wisdom that suggests that most trauma is followed by post-traumatic stress disorder (PTSD), and is best treated with critical incident stress debriefing (CISD). Instead, recent evidence suggests that many individuals exposed to stress do not experience stress responses. Even those who do, however,…

  17. Internalizing Disorders and Leukocyte Telomere Erosion: A Prospective Study of Depression, Generalized Anxiety Disorder and Post-Traumatic Stress Disorder

    Science.gov (United States)

    Shalev, Idan; Moffitt, Terrie E.; Braithwaite, Antony W.; Danese, Andrea; Fleming, Nicholas I.; Goldman-Mellor, Sidra; Harrington, HonaLee; Houts, Renate M.; Israel, Salomon; Poulton, Richie; Robertson, Stephen P.; Sugden, Karen; Williams, Benjamin; Caspi, Avshalom

    2013-01-01

    There is evidence that persistent psychiatric disorders lead to age-related disease and premature mortality. Telomere length has emerged as a promising biomarker in studies that test the hypothesis that internalizing psychiatric disorders are associated with accumulating cellular damage. We tested the association between the persistence of internalizing disorders (depression, generalized anxiety disorder and post-traumatic stress disorder) and leukocyte telomere length (LTL) in the prospective-longitudinal Dunedin Study (N=1037). Analyses showed that the persistence of internalizing disorders across repeated assessments from ages 11 to 38 years predicted shorter LTL at age 38 years in a dose-response manner, specifically in men (β= −.137, 95% CI: −.232, −.042, p=.005). This association was not accounted for by alternative explanatory factors, including childhood maltreatment, tobacco smoking, substance dependence, psychiatric medication use, poor physical health, or low socioeconomic status. Additional analyses using DNA from blood collected at two time points (ages 26 and 38 years) showed that LTL erosion was accelerated among men who were diagnosed with internalizing disorder in the interim (β= −.111, 95% CI: −.184, −.037, p=.003). No significant associations were found among women in any analysis, highlighting potential sex differences in internalizing-related telomere biology. These findings point to a potential mechanism linking internalizing disorders to accelerated biological aging in the first half of the life course, particularly in men. Because internalizing disorders are treatable, the findings suggest the hypothesis that treating psychiatric disorders in the first half of the life course may reduce the population burden of age-related disease, and extend health expectancy. PMID:24419039

  18. The validity of screening instruments for posttraumatic stress disorder, depression, and other anxiety symptoms in Tajikistan.

    Science.gov (United States)

    Hollander, Anna-Clara; Ekblad, Solvig; Mukhamadiev, Davron; Muminova, Reykhan

    2007-11-01

    Armed conflicts and violations of human rights have a large and long-lasting impact on the mental health of affected individuals. In Tajikistan's civil war, 1992-1997, out of a total population of 6.5 million, about 60,000 were killed and 700,000 became refugees. Little has been done to explore the mental health consequences of this war. The purpose of the present pilot study was to validate 1 screening instrument for PTSD and 1 for depression and anxiety symptoms in a Tajik outpatient population. The sample for the study totaled 75. The appropriate cutoff values were determined empirically. The validity of the instruments was high. In conclusion, the use of validated screening instruments was a feasible way to explore the prevalence of PTSD, depression, and other anxiety symptoms in a Tajikistan context.

  19. Traumatic experiences, posttraumatic stress symptoms, depression, and health-risk behavior in relation to injury among University of Nairobi students in Kenya.

    Science.gov (United States)

    Othieno, Caleb J; Okoth, Roselyne; Peltzer, Karl; Pengpid, Supa; Malla, Lucas O

    2015-01-01

    To describe the prevalence and types of injuries in relation to traumatic experiences, posttraumatic stress symptoms, depression, and health-risk behaviors among university students in Kenya. A cross-sectional study collected data on a random sample of university students using a questionnaire to record sociodemographic variables while injuries experiences recorded using the Centers for Disease control criteria and Breslau's seven-item screener was used to identify post-traumatic stress disorder (PTSD) symptoms. Depressive symptoms were measured using Center for Epidemiological Studies Short Depression Scale. Nine hundred and twenty-three students (525 male and 365 female) were included in the study, mean age 23 years (SD 4.0). Serious injury in the previous 12 months was reported by 29.00% of the students. PTSD was present in 15.67% (men 15.39% and women 16.1%). Out of the total, 41.33% of the students had depressive symptoms (35.71% mild-moderate symptoms and 5.62% severe). In the multivariable logistic regression being poor, binge drinking, tobacco use, ever been diagnosed with HIV, physically abused as a child, high PTSD score, and depression (adjusted odds ratio 5.49, 95% confidence interval 4.32-13.21) were significantly (p valuestudent population and are positively linked to depression and other risky behaviors. Measures aimed at improving the mental health, such as early identification and treatment of depression, may be useful in reducing the prevalence of such injuries among the youth. © The Author(s) 2015.

  20. Traumatic Severity and Trait Resilience as Predictors of Posttraumatic Stress Disorder and Depressive Symptoms among Adolescent Survivors of the Wenchuan Earthquake

    Science.gov (United States)

    Ying, Liuhua; Wu, Xinchun; Lin, Chongde; Jiang, Lina

    2014-01-01

    Purpose To examine the associations between trauma severity, trait resilience, and posttraumatic stress disorder (PTSD) and depressive symptoms among adolescent survivors of the Wenchuan earthquake, China. Methods 788 participants were randomly selected from secondary schools in the counties of Wenchuan and Maoxian, the two areas most severely affected by the earthquake. Participants completed four main questionnaires including the Child PTSD Symptom Scale, the Center for Epidemiologic Studies Depression Scale for Children, the Connor and Davidson’s Resilience Scale, and the Severity of Exposure to Earthquake Scale. Results After adjusting for the effect of age and gender, four aspects of trauma severity (i.e., direct exposure, indirect exposure, worry about others, and house damage) were positively associated with the severity of PTSD and depressive symptoms, whereas trait resilience was negatively associated with PTSD and depressive symptoms and moderated the relationship between subjective experience (i.e., worry about others) and PTSD and depressive symptoms. Conclusions Several aspects (i.e., direct exposure, indirect exposure, worry about others, and house damage) of earthquake experiences may be important risk factors for the development and maintenance of PTSD and depression. Additionally, trait resilience exhibits the beneficial impact on PTSD and depressive symptoms and buffers the effect of subjective experience (i.e., worry about others) on PTSD and depressive symptoms. PMID:24586751

  1. Attachment typologies and posttraumatic stress disorder (PTSD), depression and anxiety: a latent profile analysis approach

    OpenAIRE

    Armour, Cherie; Elklit, Ask; Shevlin, Mark

    2011-01-01

    Background: Bartholomew (1990) proposed a four category adult attachment model based on Bowlby’s (1973) proposal that attachment is underpinned by an individual’s view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS). In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status. Objective: The current stu...

  2. Residual injury, appearance-related concerns, symptoms of post-traumatic stress disorder, and depression within a treatment-seeking veteran sample.

    Science.gov (United States)

    Weaver, Terri L; Walter, Kristen H; Chard, Kathleen M; Bosch, Jeane

    2014-10-01

    This study explored the associations among injury-related appearance changes experienced during deployment/combat, symptom severity of post-traumatic stress disorder and depression, and body image distress within a treatment-seeking veteran population (n = 91). Thirty-three percent of the sample reported having an appearance-related residual injury experienced during combat or deployment (n = 30). A subsample, who completed the body image distress measure (n = 69), was divided into two groups: those with an appearance-related residual injury (n = 22) and those without an appearance-related residual injury (n = 47). Correlational analyses revealed significant, positive correlations between body image distress and depression symptom severity. Results also showed a trend relationship between body image distress and post-traumatic stress disorder symptom severity for those with an appearance-related residual injury although correlations were nonsignificant among these constructs for those without an appearance-related residual injury. Multiple regression analyses revealed that body image distress was a unique predictor of depression symptom severity, controlling for residual injury status. Implications of these findings for exploring the psychological impact of residual injury were discussed.

  3. Transtorno de estresse pós-traumático e depressão maior Posttraumatic stress disorder and major depression

    Directory of Open Access Journals (Sweden)

    Marcelo T Berlim

    2003-06-01

    Full Text Available Estudos epidemiológicos indicam, claramente, que o transtorno de estresse pós-traumático (TEPT está se tornando um importante problema de saúde em termos globais, ainda que continue sendo pouco diagnosticado e tratado de forma inapropriada. O TEPT comumente ocorre em comorbidade com outros transtornos psiquiátricos, especialmente com a depressão maior. Entretanto, a relação entre esses transtornos e o tratamento dessa complexa entidade clínica apenas recentemente passou a receber atenção da literatura especializada. Alguns autores argumentaram que elas são duas entidades distintas, enquanto outros defenderam a hipótese de que a alta prevalência dessa comorbidade pode representar um artefato derivado dos critérios diagnósticos atualmente utilizados. Com relação ao tratamento do TEPT comórbido com depressão maior, os dados disponíveis na literatura são insuficientes e não apontam para nenhuma abordagem específica, embora alguns ensaios clínicos pequenos tenham relatado a utilidade da combinação de inibidores seletivos da recaptação da serotonina com terapia cognitiva.Epidemiological studies clearly indicate that posttraumatic stress disorder (PTSD is becoming a major health concern worldwide even if still poorly recognized and not well treated. PTSD commonly co-occurs with other psychiatric disorder, especially with major depression. However, the relationship between these disorders and the treatment of this complex clinical entity are only now being addressed in the specialized literature. Some authors argued that they are two distinct entities, whereas others defended the hypothesis that the high prevalence of this comorbidity may represent an artifact derived from the diagnostic criteria currently used. Regarding the treatment of PSTD comorbid with major depression, the available data from controlled studies are insufficient to point out for a specific approach, although some small trials reported the usefulness of

  4. Post-Traumatic Stress Disorder

    Science.gov (United States)

    Post-traumatic stress disorder (PTSD) is a real illness. You can get PTSD after living through or seeing a traumatic event, such as war, a ... sexual assault, physical abuse, or a bad accident. PTSD makes you feel stressed and afraid after the ...

  5. Psychosocial assistance project decreases posttraumatic stress disorder and depression amongst primary and secondary schools students in post-war Bosnia-Herzegovina

    Directory of Open Access Journals (Sweden)

    Mevludin Hasanović

    2011-11-01

    Full Text Available Objective. To assess whether psychosocial support of the School Project of the Humanitarian Society (HS “Prijateljice (Girlfriends” had a positive effect on reducing posttraumatic consequences in Bosnia-Herzegovina primary and secondary school students, aft er the 1992-1995 war. Subjects and Methods. A stratified sample of 336 students, aged 13.5±1.6 (10 to 18 years, in primary and secondary schools, involved in psychosocial support, were compared with 72 randomly selected peers from the same schools, not involved in this project. Data were collected in December 2005 and in May 2006. Th e Children’s Depression Inventory and the Child Post-Traumatic Stress Reaction Index were utilized. Statistical analysis involved McNemar’s test, Students’ t-test, Chi-square test and Pearson’s correlation test. Results. According to DSM, the prevalence of PTSD and depression among students involved in the School Project, significantly decreased from 46.1% to 13.4% and 25.6% to 1.8%, respectively (McNemar’s test,P<0.001; P<0.001, respectively. In the control group the prevalenceof PTSP and depression decreased from 30.5% to 23.6% and 22.2%to 11.1%, respectively, with no significance (McNemar’s test, p=0.332; p=0.077, significantly. Girls had a significantly higher prevalence of both PTSD and depression compared to the boys. Age, the numberof traumatic episodes, and suicidal behavior correlated with the intensity of PTSD symptoms and depression symptoms. Conclusions.Psychosocial support within the School Project resulted in a significant reduction of PTSP and depression amongst the involved students compared to the controls. Schools and other institutions ought to envisage as many projects as possible to be implemented in school and out-of-school to assist young people to overcome more easily the consequences of the war in their development.

  6. CO-OCCURRENCE OF CHRONIC HEAD, FACE AND NECK PAIN, AND DEPRESSION IN WAR VETERANS WITH POST-TRAUMATIC STRESS DISORDER.

    Science.gov (United States)

    Muhvić-Urek, Miranda; Vukšić, Željka; Simonić-Kocijan, Sunčana; Braut, Vedrana; Braut, Alen; Uhač, Ivone

    2015-09-01

    This study investigated the relationship between chronic head, face and neck pain, and the level of depression in Croatian war veterans with post-traumatic stress disorder (PTSD). The presence of self-reported pain, pain on digital palpation, and pain severity in masticatory and neck muscles, temporomandibular joints and sinuses, as well as the level of depression were assessed in a group of war veterans with PTSD (n=52). Control groups consisted of war veterans without PTSD (n=50) and healthy men that were not engaged in war actions and were free from PTSD (n=50). The number of self-reported pain and number of painful sites were correlated with the level of depression. More self-reported pain and painful sites were recorded in the group of war veterans with PTSD as compared with either war veterans without PTSD or healthy men. Furthermore, PTSD patients mostly suffered from severe depression. There was a statistically significant positive correlation between all investigated pain parameters and level of depression. As the most important finding, the present study demonstrated chronic head, face and neck pain to be related to depression in PTSD patients.

  7. Cross-cultural gene- environment interactions in depression, post-traumatic stress disorder, and the cortisol awakening response: FKBP5 polymorphisms and childhood trauma in South Asia.

    Science.gov (United States)

    Kohrt, Brandon A; Worthman, Carol M; Ressler, Kerry J; Mercer, Kristina B; Upadhaya, Nawaraj; Koirala, Suraj; Nepal, Mahendra K; Sharma, Vidya Dev; Binder, Elisabeth B

    2015-01-01

    Despite increased attention to global mental health, psychiatric genetic research has been dominated by studies in high-income countries, especially with populations of European descent. The objective of this study was to assess single nucleotide polymorphisms (SNPs) in the FKBP5 gene in a population living in South Asia. Among adults in Nepal, depression was assessed with the Beck Depression Inventory (BDI), post-traumatic stress disorder (PTSD) with the PTSD Checklist-Civilian Version (PCL-C), and childhood maltreatment with the Childhood Trauma Questionnaire (CTQ). FKBP5 SNPs were genotyped for 682 participants. Cortisol awakening response (CAR) was assessed in a subsample of 118 participants over 3 days. The FKBP5 tag-SNP rs9296158 showed a main effect on depressive symptoms (p = 0.03). Interaction of rs9296158 and childhood maltreatment predicted adult depressive symptoms (p = 0.02) but not PTSD. Childhood maltreatment associated with endocrine response in individuals homozygous for the A allele, demonstrated by a negative CAR and overall hypocortisolaemia in the rs9296158 AA genotype and childhood maltreatment group (p depression but not PTSD. Gene-environment studies should take differences in prevalence and cultural significance of phenotypes and exposures into account when interpreting cross-cultural findings.

  8. Cognitive biases in processing infant emotion by women with depression, anxiety and post-traumatic stress disorder in pregnancy or after birth: A systematic review.

    Science.gov (United States)

    Webb, Rebecca; Ayers, Susan

    2015-01-01

    Perinatal psychological problems such as post-natal depression are associated with poor mother-baby interaction, but the reason for this is not clear. One explanation is that mothers with negative mood have biased processing of infant emotion. This review aimed to synthesise research on processing of infant emotion by pregnant or post-natal women with anxiety, depression or post-traumatic stress disorder (PTSD). Systematic searches were carried out on 11 electronic databases using terms related to negative affect, childbirth and perception of emotion. Fourteen studies were identified which looked at the effect of depression, anxiety and PTSD on interpretation of infant emotional expressions (k = 10), or reaction times when asked to ignore emotional expressions (k = 4). Results suggest mothers with depression and anxiety are more likely to identify negative emotions (i.e., sadness) and less accurate at identifying positive emotions (i.e., happiness) in infant faces. Additionally, women with depression may disengage faster from positive and negative infant emotional expressions. Very few studies examined PTSD (k = 2), but results suggest biases towards specific infant emotions may be influenced by characteristics of the traumatic event. The implications of this research for mother-infant interaction are explored.

  9. Vulnerability to posttraumatic stress disorder

    NARCIS (Netherlands)

    Lommen, M.J.J.

    2013-01-01

    Most individuals will experience a traumatic event during their lives and some will develop subsequent posttraumatic stress disorder (PTSD). PTSD is characterized by symptoms of re-experiencing the traumatic event, avoidance of reminders of the event, and hyperarousal symptoms. The thesis of Miriam

  10. Deconstructing delayed posttraumatic stress disorder

    NARCIS (Netherlands)

    Smid, G.E.

    2011-01-01

    According to the Diagnostic and Statistical Manual of Mental Disorders, delayed posttraumatic stress disorder (PTSD) must be diagnosed in individuals fulfilling criteria for PTSD if the onset of symptoms is at least six months after the trauma. The purpose of this thesis was to establish the prevale

  11. Impact of comorbid panic and posttraumatic stress disorder on outcomes of collaborative care for late-life depression in primary care.

    Science.gov (United States)

    Hegel, Mark T; Unützer, Jürgen; Tang, Lingqi; Areán, Patricia A; Katon, Wayne; Noël, Polly Hitchcock; Williams, John W; Lin, Elizabeth H B

    2005-01-01

    Comorbid anxiety disorders may result in worse depression treatment outcomes. The authors evaluated the effect of comorbid panic disorder and posttraumatic stress disorder (PTSD) on response to a collaborative-care intervention for late-life depression in primary care. A total of 1,801 older adults with depression were randomized to a collaborative-care depression treatment model versus usual care and assessed at baseline, 3, 6, and 12 months, comparing differences among participants with comorbid panic disorder (N=262) and PTSD (N=191) and those without such comorbid anxiety disorders. At baseline, patients with comorbid anxiety reported higher levels of psychiatric and medical illness, greater functional impairment, and lower quality of life. Participants without comorbid anxiety who received collaborative care had early and lasting improvements in depression compared with those in usual care. Participants with comorbid panic disorder showed similar outcomes, whereas those with comorbid PTSD showed a more delayed response, requiring 12 months of intervention to show a significant effect. At 12 months, however, outcomes were comparable. Interactions of intervention status by comorbid PTSD or panic disorder were not statistically significant, suggesting that the collaborative-care model performed significantly better than usual care in depressed older adults both with and without comorbid anxiety. Collaborative care is more effective than usual care for depressed older adults with and without comorbid panic disorder and PTSD, although a sustained treatment response was slower to emerge for participants with PTSD. Intensive and prolonged follow-up may be needed for depressed older adults with comorbid PTSD.

  12. Depression and post-traumatic stress disorder among Haitian immigrant students: implications for access to mental health services and educational programming

    Directory of Open Access Journals (Sweden)

    Muriel Anna C

    2009-12-01

    Full Text Available Abstract Background Previous studies of Haitian immigrant and refugee youth have emphasized "externalizing" behaviors, such as substance use, high risk sexual behavior, and delinquency, with very little information available on "internalizing" symptoms, such as depression and anxiety. Analyzing stressors and "internalizing" symptoms offers a more balanced picture of the type of social and mental health services that may be needed for this population. The present study aims to: 1 estimate the prevalence of depression and post-traumatic stress disorder (PTSD among Haitian immigrant students; and 2 examine factors associated with depression and PTSD to identify potential areas of intervention that may enhance psychosocial health outcomes among immigrant youth from Haiti in the U.S. Methods A stratified random sample of Haitian immigrant students enrolled in Boston public high schools was selected for participation; 84% agreed to be interviewed with a standardized questionnaire. Diagnosis of depression and PTSD was ascertained using the best estimate diagnosis method. Results The prevalence estimates of depression and PTSD were 14.0% and 11.6%; 7.9% suffered from comorbid PTSD and depression. Multivariate logistic regression demonstrated factors most strongly associated with depression (history of father's death, self-report of schoolwork not going well, not spending time with friends and PTSD (concern for physical safety, having many arguments with parents, history of physical abuse, and lack of safety of neighborhood. Conclusions A significant level of depression and PTSD was observed. Stressors subsequent to immigration, such as living in an unsafe neighborhood and concern for physical safety, were associated with an increased risk of PTSD and should be considered when developing programs to assist this population. Reducing exposure to these stressors and enhancing access to social support and appropriate school-based and mental health services

  13. Posttraumatic stress and immune dissonance

    Institute of Scientific and Technical Information of China (English)

    JIANG Jian-xin

    2008-01-01

    @@ Stress or neuroendocrine response usually occurs soon after trauma, which is central to the maintenance of posttraumatic homeostasis. Immune inflammatory response has been recognized to be a key element both in the pathogenesis of post-traumatic complications and in tissue repair. Despite the existence of multiple and intricate interconnected neuroendocrine pathways, the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system have been considered to be the most important in trauma. Although the short-term and appropriate activation of these

  14. The Emerging Role of Mindfulness Meditation as Effective Self-Management Strategy, Part 1: Clinical Implications for Depression, Post-Traumatic Stress Disorder, and Anxiety.

    Science.gov (United States)

    Khusid, Marina A; Vythilingam, Meena

    2016-09-01

    Mindfulness-based interventions (MBIs) have been increasingly utilized in the management of mental health conditions. This first review of a two-part series evaluates the efficacy, mechanism, and safety of mindfulness meditation for mental health conditions frequently seen after return from deployment. Standard databases were searched until August 4, 2015. 52 systematic reviews and randomized clinical trials were included. The Strength of Recommendation (SOR) Taxonomy was used to assess the quality of individual studies and to rate the strength of evidence for each clinical condition. Adjunctive mindfulness-based cognitive therapy is effective for decreasing symptom severity during current depressive episode, and for reducing relapse rate in recovered patients during maintenance phase of depression management (SOR moderate [SOR B]). Adjunctive mindfulness-based stress reduction is effective for improving symptoms, mental health-related quality of life, and mindfulness in veterans with combat post-traumatic stress disorder (PTSD) (SOR B). Currently, there is no sufficient data to recommend MBIs for generalized anxiety disorder (SOR B). MBIs are safe, portable, cost-effective, and can be recommended as an adjunct to standard care or self-management strategy for major depressive disorder and PTSD. Future large, well-designed randomized clinical trials in service members and veterans can help plan for the anticipated increase in demand for behavioral health services.

  15. Impact of depression and post-traumatic stress disorder on functional outcome and health-related quality of life of patients with mild traumatic brain injury.

    Science.gov (United States)

    Haagsma, Juanita A; Scholten, Annemieke C; Andriessen, Teuntje M J C; Vos, Pieter E; Van Beeck, Ed F; Polinder, Suzanne

    2015-06-01

    The impact of disability following traumatic brain injury (TBI), assessed by functional measurement scales for TBI or by health-related quality of life (HRQoL), may vary because of a number of factors, including presence of depression or post-traumatic stress disorder (PTSD). The aim of this study was to assess prevalence and impact of depression and PTSD on functional outcome and HRQoL six and 12 months following mild TBI. We selected a sample of 1919 TBI patients who presented to the emergency department (ED) followed by either hospital admission or discharge to the home environment. The sample received postal questionnaires six and 12 months after treatment at the ED. The questionnaires included items regarding socio-demographics, the 36-item Short-Form Health Survey (SF-36), the Perceived Quality of Life Scale (PQoL), the Beck Depression Inventory, and the Impact of Event Scale. A total of 797 (42%) TBI patients completed the six-month follow-up survey. Depression and PTSD prevalence rates at both the six- and 12-month follow-up were 7% and 9%, respectively. Living alone was an independent predictor of depression and/or PTSD at six- and 12-month follow-up. Depression and PTSD were associated with a significantly decreased functional outcome (measured with Glasgow Outcome Scale Extended) and HRQoL (measured using the SF-36 and the PQoL). We conclude that depression and/or PTSD are relatively common in our sample of TBI patients and associated with a considerable decrease in functional outcome and HRQoL.

  16. Meditation for Posttraumatic Stress Disorder: A Systematic Review

    Science.gov (United States)

    2017-01-01

    Post-Traumatic Stress Working Group, 2010) The guideline recommends that mindfulness, yoga, and other CAM approaches that facilitate relaxation may be...Behavioral Activation for Depression Scale, BSI-18, Brunel Mood Scales, and Depression Anxiety Stress Scale-21 (Bormann et al., 2008; Bormann et al., 2013... Stress Disorder,” Journal of Physical Activity and Health, July 14, 2015. Fiore, Rachael, Rhonda Nelson, and Eric Tosti, “The Use of Yoga, Meditation

  17. The perioperative implications of posttraumatic stress disorder.

    Science.gov (United States)

    Wofford, Ken; Hertzberg, Michael; Vacchiano, Charles

    2012-12-01

    Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after exposure to a traumatic event and is characterized by symptoms of reexperiencing, emotional numbing, persistent arousal, and avoidance. Approximately 6.8% of the people in the United States will be diagnosed with PTSD at some point in their lives. The presence of PTSD in a surgical patient can be important because PTSD is associated with the use of psychoactive medications, risky health behaviors, cardiovascular comorbidities, depression, chronic pain, and cognitive dysfunction, all of which may influence the risk of perioperative morbidity and mortality. In addition, patients with PTSD are anxious around unfamiliar people and in unfamiliar environments. The purposes of this journal course are to provide anesthetists with a working knowledge of the symptoms, treatments, and comorbidities associated with PTSD and to suggest ways of interacting with patients with the disorder that increase trust and decrease the risk of evoking posttraumatic symptoms in the perioperative environment.

  18. Pharmacotherapy for posttraumatic stress disorder.

    Science.gov (United States)

    Stein, D J; Zungu-Dirwayi, N; van Der Linden GJ; Seedat, S

    2000-01-01

    Posttraumatic stress disorder (PTSD) is a prevalent and disabling disorder. By definition prior psychological trauma plays a causal role in the disorder, and psychotherapy is a widely accepted intervention. Nevertheless there is growing evidence that PTSD is characterized by specific psychobiological dysfunctions, and this has contributed to a growing interest in the use of medication in its treatment. The authors aimed to undertake a systematic review of randomized controlled trials (RCTs) of the pharmacotherapy of posttraumatic stress disorder (PTSD) following the guidelines and using the software of the Cochrane Collaboration, and to provide an estimate of the effects of medication in this disorder. Secondary objectives were to explore questions about whether particular classes of medication are more effective and/or acceptable than others in the treatment of PTSD, and about which factors (clinical and methodological) predict response to pharmacotherapy. Studies of the pharmacotherapy of PTSD were identified using literature searches of MEDLINE (1966 to 1999, using the textwords posttraumatic, post-traumatic, medication, pharmacotherapy) and other electronic databases (PSYCLIT; National PTSD Center Pilots database; Dissertation Abstracts; Cochrane Collaboration Depression, Anxiety & Neurosis Controlled Trials Register). In addition, published and unpublished RCTs were requested from PTSD researchers and pharmaceutical companies. An initial broad strategy was undertaken to find not only RCTs, but also open-label trials and reviews of the pharmacotherapy of PTSD; additional studies were sought in reference lists of retrieved articles and included studies in any language. All RCTs of PTSD (including both placebo controlled and comparative trials), whether published or unpublished, but completed prior to the end of 1999 were considered for the review. Selected RCTs were independently assessed and collated by 2 raters, and Review Manager (RevMan) software was used to

  19. Posttraumatic stress disorder and not depression is associated with shorter leukocyte telomere length: findings from 3,000 participants in the population-based KORA F4 study.

    Directory of Open Access Journals (Sweden)

    Karl-Heinz Ladwig

    Full Text Available BACKGROUND: A link between severe mental stress and shorter telomere length (TL has been suggested. We analysed the impact of Posttraumatic Stress Disorder (PTSD on TL in the general population and postulated a dose-dependent TL association in subjects suffering from partial PTSD compared to full PTSD. METHODS: Data are derived from the population-based KORA F4 study (2006-2008, located in southern Germany including 3,000 individuals (1,449 men and 1,551 women with valid and complete TL data. Leukocyte TL was measured using a quantitative PCR-based technique. PTSD was assessed in a structured interview and by applying the Posttraumatic Diagnostic Scale (PDS and the Impact of Event Scale (IES. A total of 262 (8.7% subjects qualified for having partial PTSD and 51 (1.7% for full PTSD. To assess the association of PTSD with the average TL, linear regression analyses with adjustments for potential confounding factors were performed. RESULTS: The multiple model revealed a significant association between partial PTSD and TL (beta = -0.051, p = 0.009 as well as between full PTSD and shorter TL (beta = -0.103, p = 0.014 indicating shorter TL on average for partial and full PTSD. An additional adjustment for depression and depressed mood/exhaustion gave comparable beta estimations. CONCLUSIONS: Participants with partial and full PTSD had significantly shorter leukocyte TL than participants without PTSD. The dose-dependent variation in TL of subjects with partial and full PTSD exceeded the chronological age effect, and was equivalent to an estimated 5 years in partial and 10 years in full PTSD of premature aging.

  20. Rationale and study protocol for a multi-component Health Information Technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting.

    Science.gov (United States)

    Biegler, Kelly; Mollica, Richard; Sim, Susan Elliott; Nicholas, Elisa; Chandler, Maria; Ngo-Metzger, Quyen; Paigne, Kittya; Paigne, Sompia; Nguyen, Danh V; Sorkin, Dara H

    2016-09-01

    The prevalence rate of depression in primary care is high. Primary care providers serve as the initial point of contact for the majority of patients with depression, yet, approximately 50% of cases remain unrecognized. The under-diagnosis of depression may be further exacerbated in limited English-language proficient (LEP) populations. Language barriers may result in less discussion of patients' mental health needs and fewer referrals to mental health services, particularly given competing priorities of other medical conditions and providers' time pressures. Recent advances in Health Information Technology (HIT) may facilitate novel ways to screen for depression and other mental health disorders in LEP populations. The purpose of this paper is to describe the rationale and protocol of a clustered randomized controlled trial that will test the effectiveness of an HIT intervention that provides a multi-component approach to delivering culturally competent, mental health care in the primary care setting. The HIT intervention has four components: 1) web-based provider training, 2) multimedia electronic screening of depression and PTSD in the patients' primary language, 3) Computer generated risk assessment scores delivered directly to the provider, and 4) clinical decision support. The outcomes of the study include assessing the potential of the HIT intervention to improve screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post-traumatic stress disorder (PTSD) among LEP Cambodian refugees who experienced war atrocities and trauma during the Khmer Rouge. This technology has the potential to be adapted to any LEP population in order to facilitate mental health screening and treatment in the primary care setting.

  1. Posttraumatic stress among youths in juvenile detention.

    Science.gov (United States)

    Falk, Derek; Thompson, Sanna J; Sanford, Julia

    2014-01-01

    An estimated 1.8 million juveniles were arrested in the United States for delinquency in 2009. Previous studies indicate high rates of exposure to traumatic events and posttraumatic stress (PTS) symptoms for these youths. This study examined PTS in a sample of 170 youths in juvenile detention. The results of this study reveal higher rates of PTS symptoms (21%) compared to national rates (6%). The data also suggest youths suffering from more PTS symptoms also report higher depression, anxiety, anger, family relationship worries, thought problems, and attention problems. These factors provide a direction for continued practice targeting these youths.

  2. Military service member and veteran self reports of efficacy of cranial electrotherapy stimulation for anxiety, posttraumatic stress disorder, insomnia, and depression.

    Science.gov (United States)

    Kirsch, Daniel L; Price, Larry R; Nichols, Francine; Marksberry, Jeffrey A; Platoni, Katherine T

    2014-01-01

    Cranial electrotherapy stimulation (CES) is being prescribed for service members and veterans for the treatment of anxiety, posttraumatic stress disorder (PTSD), insomnia and depression. The purpose of this study was to examine service members' and veterans' perceptions of the effectiveness and safety of CES treatment. Service members and veterans (N=1,514) who had obtained a CES device through the Department of Defense or Veterans Affairs Medical Center from 2006-2011 were invited to participate in the web based survey via email. One hundred fifty-two participants returned questionnaires. Data were analyzed using descriptive statistics. Participants reported clinical improvement of 25% or more from using CES for anxiety (66.7%), PTSD (62.5%), insomnia (65.3%) and depression (53.9%). The majority of these participants reported clinical improvement of 50% or more. Respondents also perceived CES to be safe (99.0%). Those individuals who were not taking any prescription medication rated CES more effective than the combined CES and prescription medication group. CES provides service members and veterans with a safe, noninvasive, nondrug, easy to use treatment for anxiety, PTSD, insomnia, and depression that can be used in the clinical setting or self-directed at home.

  3. Cognitive behavioral therapy for post-traumatic stress disorder, depression, or anxiety disorders in women and girls living with female genital mutilation: A systematic review.

    Science.gov (United States)

    Adelufosi, Adegoke; Edet, Bassey; Arikpo, Dachi; Aquaisua, Ememobong; Meremikwu, Martin M

    2017-02-01

    Female genital mutilation (FGM) is associated with psychological consequences such as post-traumatic stress disorder (PSTD), depression, and anxiety disorders. Cognitive behavioral therapy (CBT), an empirically supported form of psychotherapy, may be an effective treatment for these psychological sequelae of FGM. To assess the effectiveness of CBT among individuals living with any type of FGM and diagnosed to have PTSD, depression, or anxiety disorders. CENTRAL, Medline, African Index Medicus, SCOPUS, PILOTS, POPLINE, PsycINFO, WHOLIS, LILACS, ERIC, NYAM Library, CINAHL, Web of Science were searched from inception up to August 10, 2015. Both randomized and nonrandomized studies comparing the efficacy of CBT to other forms of interventions for PTSD, depression, or anxiety disorders in individuals with FGM, were systematically reviewed. We did not identify any studies with eligible design that addressed the objective of the review. There are no included studies. Future studies need to look beyond establishing the prevalence and correlates of FGM to conducting well-designed, randomized controlled studies or well-designed interventional observational studies for the management of the psychological consequences of women and girls living with FGM. CRD42015024458. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  4. Moderate treadmill exercise rescues anxiety and depression-like behavior as well as memory impairment in a rat model of posttraumatic stress disorder.

    Science.gov (United States)

    Patki, Gaurav; Li, Lumeng; Allam, Farida; Solanki, Naimesh; Dao, An T; Alkadhi, Karim; Salim, Samina

    2014-05-10

    Post-traumatic stress disorder (PTSD) is a condition which can develop from exposure to a severe traumatic event such as those occurring during wars or natural disasters. Benzodiazepines and selective serotonin reuptake inhibitors (SSRIs) are considered the gold standard for PTSD treatment, but their side effects pose a serious problem. While regular physical exercise is regarded as a mood elevator and known to enhance cognitive function, its direct role in rescuing core symptoms of PTSD including anxiety and depression-like behaviors and cognitive impairment is unclear. In the present study using the single-prolonged stress (SPS) rat model of PTSD (2h restrain, 20 min forced swimming, 15 min rest, and 1-2 min diethyl ether exposure), we examined the beneficial effect of moderate treadmill exercise on SPS-induced behavioral deficits including anxiety and depression-like behaviors and memory impairment. Male Wistar rats were randomly assigned into four groups: control (sedentary), exercised, SPS (no exercise), or SPS-exercised. Rats were exercised on a rodent treadmill for 14 consecutive days. Rats in all groups were tested for anxiety-like behaviors using open field (OF), light-dark and elevated-plus maze tests. All rats were tested for short-term and long-term memory in the radial arm water maze test. Rats were then sacrificed, blood was collected (for corticosterone levels), and individual organs (spleen, adrenals, and thymus) harvested. Results suggest that moderate physical exercise ameliorates SPS-induced behavioral deficits in rats.

  5. Direction of Influence between Posttraumatic and Depressive Symptoms during Prolonged Exposure Therapy among Children and Adolescents

    Science.gov (United States)

    Aderka, Idan M.; Foa, Edna B.; Applebaum, Edna; Shafran, Naama; Gilboa-Schechtman, Eva

    2011-01-01

    Objective: Our objective in the present study was to examine the temporal sequencing of posttraumatic and depressive symptoms during prolonged exposure therapy for posttraumatic stress disorder (PTSD) among children and adolescents. Method: Participants were 73 children and adolescents (56.2% female) between the ages of 8 and 18. Participants…

  6. Comparison of anxiety, depression, and post-traumatic stress symptoms in relatives of ICU patients in an American and an Indian public hospital

    Directory of Open Access Journals (Sweden)

    Hrishikesh S Kulkarni

    2011-01-01

    Full Text Available Context: An intensive care unit (ICU admission of a patient causes considerable stress among relatives. Whether this impact differs among populations with differing sociocultural factors is unknown. Aims: The aim was to compare the psychological impact of an ICU admission on relatives of patients in an American and Indian public hospital. Settings and Design: A cross-sectional study was carried out in ICUs of two tertiary care hospitals, one each in major metropolitan cities in the USA and India. Materials and Methods: A total of 90 relatives visiting patients were verbally administered a questionnaire between 48 hours and 72 hours of ICU admission that included the Hospital Anxiety and Depression Scale (HADS, Beck Depression Inventory-II (BDI-II and Impact of Events Scale-Revised (IES-R for post-traumatic stress response. Statistical Analysis: Statistical analysis was done using the Mann-Whitney and chi-square tests. Results: Relatives in the Indian ICU had more anxiety symptoms (median HADS-A score 11 [inter-quartile range 9-13] vs. 4 [1.5-6] in the American cohort; P30. 55% of all relatives had an incongruous perception regarding "change in the patient′s condition" compared to the objective change in severity of illness. "Change in worry" was incongruous compared to the "perception of improvement of the patient′s condition" in 78% of relatives. Conclusions: Relatives of patients in the Indian ICU had greater anxiety and depression symptoms compared to those in the American cohort, and had significant differences in factors that may be associated with this psychological impact. Both groups showed substantial discordance between the perceived and objective change in severity of illness.

  7. Altered functional connectivity in posttraumatic stress disorder with versus without comorbid major depressive disorder: a resting state fMRI study.

    Science.gov (United States)

    Kennis, Mitzy; Rademaker, Arthur R; van Rooij, Sanne J H; Kahn, René S; Geuze, Elbert

    2013-01-01

    Posttraumatic stress disorder (PTSD) is an anxiety disorder that is often diagnosed with comorbid depressive disorder. Therefore, neuroimaging studies investigating PTSD typically include both patients with and without comorbid depression. Differences in activity of the anterior cingulate cortex (ACC) and insula have been shown to differentiate PTSD patients with and without major depressive disorder (MDD). Whether or not comorbid MDD affects resting state functional connectivity of PTSD patients has not been investigated to our knowledge. Here, resting state functional connectivity of PTSD patients with (PTSD+MDD; n=27) and without (PTSD-MDD; n=23) comorbid MDD was investigated. The subgenual ACC and insula were investigated as seed regions. Connectivity between the subgenual ACC and perigenual parts of the ACC was increased in PTSD+MDD versus PTSD-MDD, which may reflect the presence of depressive specific symptoms such as rumination. Functional connectivity of the subgenual ACC with the thalamus was reduced, potentially related to more severe deficits in executive functioning in the PTSD+MDD group versus the PTSD-MDD group. In addition, the PTSD+MDD group showed reduced functional connectivity of the insula with the hippocampus compared to the PTSD-MDD group. However, this cluster was no longer significantly different when PTSD patients that were using medication were excluded from analyses. Thus, resting state functional connectivity of the subgenual ACC can distinguish PTSD+MDD from PTSD-MDD, and this may therefore be used as a neurobiological marker for comorbid MDD in the presence of PTSD. As PTSD+MDD are more treatment resistant, these findings can also guide treatment development, for example by targeting the subgenual ACC network with treatment.

  8. Posttraumatic Stress Disorder obesity and weight loss

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

    directional. The purpose of the present study was to examine whether the level of PTSD symptoms decrease as a result of weight loss in 30 obese participants during a 16 week stay at a weight loss facility. During the 16 weeks participants’ Body Mass Index (BMI) decreased significantly. Concurrently...... of depression also declined, whereas perceived social support was stable. The fact that the level of PTSD symptoms decreases simultaneously with weight loss is an interesting and positive side effect that has not been reported previously. The findings are discussed in term of cognitive theories of PTSD.......Posttraumatic Stress Disorder (PTSD) has frequently been found to have a significant impact on the development of obesity. Yet, while a reciprocal relationship has been found between obesity and depression, the relationship between past traumatic episodes and obesity is usually thought of as uni...

  9. High-intensity sports for posttraumatic stress disorder and depression: feasibility study of ocean therapy with veterans of Operation Enduring Freedom and Operation Iraqi Freedom.

    Science.gov (United States)

    Rogers, Carly M; Mallinson, Trudy; Peppers, Dominique

    2014-01-01

    In this study, we conducted a pretest-posttest investigation of a sports-oriented occupational therapy intervention using surfing in an experiential, skills-based program to support veterans with symptoms of posttraumatic stress disorder (PTSD) in their transition to civilian life. The purpose of this feasibility study was to evaluate the intervention for attendance rates and retention in the program provided in 5 sessions over 5 wk. Fourteen veterans from a specialty postdeployment clinic at a Veterans Affairs hospital were enrolled; 11 completed the study, and 10 attended ≥3 sessions. Participants reported clinically meaningful improvement in PTSD symptom severity (PTSD Checklist-Military Version, Wilcoxon signed rank Z = 2.5, p = .01) and in depressive symptoms (Major Depression Inventory, Wilcoxon signed rank Z = 2.05, p = .04). The results of this small, uncontrolled study suggest that a sports-oriented occupational therapy intervention has potential as a feasible adjunct intervention for veterans seeking mental health treatment for symptoms of PTSD.

  10. Concurrent and prospective associations of habitual overgeneral memory and prospection with symptoms of depression, general anxiety, obsessive compulsiveness, and post-traumatic stress.

    Science.gov (United States)

    Boelen, Paul A; Huntjens, Rafaele J C; van den Hout, Marcel A

    2014-01-01

    Reduced memory specificity is associated with depression, post-traumatic stress disorder (PTSD), and some other forms of psychopathology. Reduced memory specificity is also associated with reduced specificity of envisioned future events. Research in this area has mostly relied on cue-word methods that include explicit instructions to develop specific memories of future events. These methods are limited in their ability to assess how participants habitually remember the past and imagine the future when the specificity constraints inherent in the cue-word task are removed. Sentence completions tasks have been developed that can be used to assess habitual patterns of memory and prospection. Little is known about the association of habitual memory and prospection with concurrently and prospectively assessed psychopathology. In the current study 142 participants completed sentence completion tasks tapping habitual memory and prospection at baseline and completed measures tapping psychological symptoms at baseline and 1 year later. Among other things, it was found that reduced memory specificity (but not reduced future specificity) was associated with concurrent and later depression, as well as with symptom levels of PTSD tapped 1 year beyond baseline.

  11. Effects of cortisol on memory in women with borderline personality disorder: role of co-morbid post-traumatic stress disorder and major depression.

    Science.gov (United States)

    Wingenfeld, K; Driessen, M; Terfehr, K; Schlosser, N; Fernando, S Carvalho; Otte, C; Beblo, T; Spitzer, C; Löwe, B; Wolf, O T

    2013-03-01

    Stress and cortisol administration are known to have impairing effects on memory retrieval in healthy humans. These effects are reported to be altered in patients with major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) but they have not yet been investigated in borderline personality disorder (BPD). In a placebo-controlled cross-over study, 71 women with BPD and 40 healthy controls received either placebo or 10 mg of hydrocortisone orally before undertaking a declarative memory retrieval task (word list learning) and an autobiographical memory test (AMT). A working memory test was also applied. Overall, opposing effects of cortisol on memory were observed when comparing patients with controls. In controls, cortisol had impairing effects on memory retrieval whereas in BPD patients cortisol had enhancing effects on memory retrieval of words, autobiographical memory and working memory. These effects were most pronounced for specificity of autobiographical memory retrieval. Patients with BPD alone and those with co-morbid PTSD showed this effect. We also found that co-morbid MDD influenced the cortisol effects: in this subgroup (BPD + MDD) the effects of cortisol on memory were absent. The present results demonstrate beneficial effects of acute cortisol elevations on hippocampal-mediated memory processes in BPD. The absence of these effects in patients with co-morbid MDD suggests that these patients differ from other BPD patients in terms of their sensitivity to glucocorticoids (GCs).

  12. Post-traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    M Yadollahie

    2011-12-01

    Full Text Available Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD. Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack, being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed “acute PTSD,” otherwise, it is called “chronic PTSD.” 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%–40%; the rate in rescue workers was 10%–20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%–32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%, firefighters (21%, and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work

  13. Post-traumatic Stress Disorder.

    Science.gov (United States)

    Javidi, H; Yadollahie, M

    2012-01-01

    Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed "acute PTSD," otherwise, it is called "chronic PTSD." 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%-40%; the rate in rescue workers was 10%-20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%-32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%), firefighters (21%), and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work-related PTSD. Working with

  14. Cognitive Behavioral Social Rhythm Group Therapy for Veterans with posttraumatic stress disorder, depression, and sleep disturbance: Results from an open trial.

    Science.gov (United States)

    Haynes, Patricia L; Kelly, Monica; Warner, Lesley; Quan, Stuart F; Krakow, Barry; Bootzin, Richard R

    2016-03-01

    Cognitive Behavioral Social Rhythm Therapy (CBSRT) is a group psychotherapy tailored for Veterans with Posttraumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD), and sleep disturbances. The aims of this study were to introduce and present initial outcomes of Cognitive Behavioral Social Rhythm Therapy (CBSRT), a 12-week skills group therapy designed to improve sleep and mood by reducing chaotic or isolated lifestyles in Veterans with PTSD. Twenty-four male Veterans with at least moderate PTSD and MDD participated in this open trial. Main outcomes were the daily sleep diary for sleep disturbances, the Clinician-Administered PTSD Scale (CAPS) for PTSD, and the Hamilton Depression Rating scale for MDD. Veterans improved on all measures (a) with large within subject effects on PTSD symptoms, MDD symptoms, and sleep quality, and (b) with 46-58% of the sample receiving clinically significant benefits on MDD and PTSD symptoms respectively. The consistency of social rhythms was associated with the average reduction in global CAPS scores over time. Only 13% of participants dropped-out of the group therapy prematurely suggesting that this new group therapy is relatively well-tolerated by Veterans. Future research that employs a control condition is necessary to establish efficacy of CBSRT. Data from this initial pilot study demonstrate that CBSRT may be an effective group treatment option for Veterans presenting with all three symptom complaints. These data also suggest that daily routine may be an important mechanism to consider in the treatment of PTSD symptoms comorbid with depression. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Procedural validity of the AUDADIS-5 depression, anxiety and post-traumatic stress disorder modules: substance abusers and others in the general population*

    Science.gov (United States)

    Hasin, Deborah S.; Shmulewitz, Dvora; Stohl, Malka; Greenstein, Eliana; Aivadyan, Christina; Morita, Kara; Saha, Tulshi; Aharonovich, Efrat; Jung, Jeesun; Zhang, Haitao; Nunes, Edward V.; Grant, Bridget F.

    2016-01-01

    Background Little is known about the procedural validity of lay-administered, fully-structured assessments of depressive, anxiety and post-traumatic stress (PTSD) disorders in the general population as determined by comparison to clinical re-appraisal, and whether this differs between current regular substance abusers and others. We evaluated the procedural validity of the Alcohol Use Disorder and Associated Disabilities Interview Schedule, DSM-5 Version (AUDADIS-5) assessment of these disorders through clinician re-interviews. Methods Test-retest design among respondents from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III): (264 current regular substance abusers, 447 others). Clinicians blinded to AUDADIS-5 results administered the semi-structured Psychiatric Research Interview for Substance and Mental Disorders, DSM-5 version (PRISM-5). AUDADIS-5/PRISM-5 concordance was indicated by kappa (κ) for diagnoses and intraclass correlation coefficients (ICC) for dimensional measures (DSM-5 symptom or criterion counts). Results were compared between current regular substance abusers and others. Results AUDADIS-5 and PRISM-5 concordance for DSM-5 depressive disorders, anxiety disorders and PTSD was generally fair to moderate (κ =0.24–0.59), with concordance on dimensional scales much better (ICC=0.53–0.81). Concordance differed little between regular substance abusers and others. Conclusions AUDADIS-5/PRISM-5 concordance indicated procedural validity for the AUDADIS-5 among substance abusers and others, suggesting that AUDADIS-5 diagnoses of DSM-5 depressive, anxiety and PTSD diagnoses are informative measures in both groups in epidemiologic studies. The stronger concordance on dimensional measures supports the current movement towards dimensional psychopathology measures, suggesting that such measures provide important information for research in the NESARC-III and other datasets, and possibly for clinical purposes as well. PMID

  16. Anxiety- and depressive-like responses and c-fos activity in preproenkephalin klockout mice: Oversensitivity hypothesis of enkephalin deficit-induced posttraumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Shyu Bai-Chuang

    2010-04-01

    Full Text Available Abstract The present study used the preproenkephalin knockout (ppENK mice to test whether the endogenous enkephalins deficit could facilitate the anxiety- and depressive-like symptoms of posttraumatic stress disorder (PTSD. On Day 1, sixteen wildtype (WT and sixteen ppENK male mice were given a 3 mA or no footshock treatment for 10 seconds in the footshock apparatus, respectively. On Days 2, 7, and 13, all mice were given situational reminders for 1 min per trial, and the freezing response was assessed. On Day 14, all mice were tested in the open field test, elevated plus maze, light/dark avoidance test, and forced swim test. Two hours after the last test, brain tissues were stained to examine c-fos expression in specific brain areas. The present results showed that the conditioned freezing response was significant for different genotypes (ppENK vs WT. The conditioned freezing effect of the ppENK mice was stronger than those of the WT mice. On Day 14, the ppENK mice showed more anxiety- and depressive-like responses than WT mice. The magnitude of Fos immunolabeling was also significantly greater in the primary motor cortex, bed nucleus of the stria terminalis-lateral division, bed nucleus of the stria terminalis-supracapsular division, paraventricular hypothalamic nucleus-lateral magnocellular part, central nucleus of the amygdala, and basolateral nucleus of the amygdala in ppENK mice compared with WT mice. In summary, animals with an endogenous deficit in enkephalins might be more sensitive to PTSD-like aversive stimuli and elicit stronger anxiety and depressive PTSD symptoms, suggesting an oversensitivity hypothesis of enkephalin deficit-induced PTSD.

  17. Mindfulness-based stress reduction for posttraumatic stress symptoms: building acceptance and decreasing shame.

    Science.gov (United States)

    Goldsmith, Rachel E; Gerhart, James I; Chesney, Samantha A; Burns, John W; Kleinman, Brighid; Hood, Megan M

    2014-10-01

    Mindfulness-based psychotherapies are associated with reductions in depression and anxiety. However, few studies address whether mindfulness-based approaches may benefit individuals with posttraumatic stress symptoms. The current pilot study explored whether group mindfulness-based stress reduction therapy reduced posttraumatic stress symptoms, depression, and negative trauma-related appraisals in 9 adult participants who reported trauma exposure and posttraumatic stress or depression. Participants completed 8 sessions of mindfulness-based stress reduction treatment, as well as pretreatment, midtreatment, and posttreatment assessments of psychological symptoms, acceptance of emotional experiences, and trauma appraisals. Posttraumatic stress symptoms, depression, and shame-based trauma appraisals were reduced over the 8-week period, whereas acceptance of emotional experiences increased. Participants' self-reported amount of weekly mindfulness practice was related to increased acceptance of emotional experiences from pretreatment to posttreatment. Results support the utility of mindfulness-based therapies for posttraumatic stress symptoms and reinforce studies that highlight reducing shame and increasing acceptance as important elements of recovery from trauma.

  18. [Clinical forms of post-traumatic depression].

    Science.gov (United States)

    Auxéméry, Y

    2015-09-01

    As a result of determinants specific to the psychopathological structure of the psychological trauma, psycho-traumatised patients very rarely solicit the health care system directly with a request for treatment centred on their trauma. The medical profession is consulted for non-specific symptoms and complications, which are mainly somatoform, addictions and depressive disorders. After a few epidemiological reminders followed by a discussion concerning contemporary depressive and post-traumatic nosographic features, we define, through our clinical experience collated with the data in the literature, different clinical and etiopathogenic contexts of post-traumatic depression in order to control their therapeutic treatment. Burnout post-traumatic depression in response to re-experiencing is the most common: it is a reactive psycho-physiological burnout in response to the emotional distress re-experienced during flashbacks, insomnia, a constant feeling of insecurity and the deleterious consequences of this symptomatology in terms of social adaptation. A common genetic predisposition affecting serotoninergic regulation seems to be a vulnerability marker of both depressive and psychotraumatic symptoms. In this case, SSRI will be effective on sadness. In addition, these antidepressants have been widely prescribed for the first-line treatment of depressive and psychotraumatic symptoms. However, this pharmacological class is often insufficient in relieving autonomic hyperactivity such as re-experiencing which are mediated more by noradrenergic hyperactivity. SNRI such as venlafaxine can be used as a first-line treatment. Post-traumatic depression with psychotic features congruent with mood is dominated by a feeling of incurability; the subject blames himself and feels guilty about the traumatic event and its consequences. Symptoms of denial of identity are sometimes observed: confined by an intense depersonalization, the psycho-traumatised subject evokes that he is "no

  19. Traumatic events and posttraumatic stress in childhood.

    Science.gov (United States)

    Copeland, William E; Keeler, Gordon; Angold, Adrian; Costello, E Jane

    2007-05-01

    Traumatic events are common and are related to psychiatric impairment in childhood. Little is known about the risk for posttraumatic stress disorder (PTSD) across different types of trauma exposure in children. To examine the developmental epidemiology of potential trauma and posttraumatic stress (PTS) in a longitudinal community sample of children. A representative population sample of 1420 children aged 9, 11, and 13 years at intake were followed up annually through 16 years of age. Main Outcome Measure Traumatic events and PTS were assessed from child and parent reports annually to 16 years of age. Risk factors and DSM-IV disorders were also assessed. More than two thirds of children reported at least 1 traumatic event by 16 years of age, with 13.4% of those children developing some PTS symptoms. Few PTS symptoms or psychiatric disorders were observed for individuals experiencing their first event, and any effects were short-lived. Less than 0.5% of children met the criteria for full-blown DSM-IV PTSD. Violent or sexual trauma were associated with the highest rates of symptoms. The PTS symptoms were predicted by previous exposure to multiple traumas, anxiety disorders, and family adversity. Lifetime co-occurrence of other psychiatric disorders with traumatic events and PTS symptoms was high, with the highest rates for anxiety and depressive disorders. In the general population of children, potentially traumatic events are fairly common and do not often result in PTS symptoms, except after multiple traumas or a history of anxiety. The prognosis after the first lifetime trauma exposure was generally favorable. Apart from PTSD, traumatic events are related to many forms of psychopathology, with the strongest links being with anxiety and depressive disorders.

  20. What are the risk factors for the comorbidity of posttraumatic stress disorder and depression in a war-affected population? a cross-sectional community study in South Sudan

    Directory of Open Access Journals (Sweden)

    Ayazi Touraj

    2012-10-01

    Full Text Available Abstract Background Limited data exists on the association of war trauma with comorbid posttraumatic stress disorder (PTSD-depression in the general population of low-income countries. The present study aimed to evaluate socioeconomic and trauma-related risk factors associated with PTSD, depression, and PTSD-depression comorbidity in the population of Greater Bahr el Ghazal States, South Sudan. Methods In this cross-sectional community study (n=1200 we applied the Harvard Trauma Questionnaire (HTQ and MINI International Neuropsychiatric Interview (MINI to investigate the prevalence of PTSD, depression, and PTSD-depression comorbidity. Multinomial logistic regression analyses were conducted to examine the association between these disorders, previous trauma exposure, sociodemographic, and socioeconomic factors. Results PTSD only was found in 331 (28% and depression only in 75 (6.4% of the study population. One hundred and twelve (9.5% of the participants had PTSD-depression comorbid diagnosis. Exposure to traumatic events and socioeconomic disadvantage were significantly associated with having PTSD or PTSD-depression comorbidity but not with depression. Participants with a comorbid condition were more likely to be socioeconomic disadvantaged, have experienced more traumatic events, and showed higher level of psychological distress than participants with PTSD or depression alone. Conclusions In individuals exposed to war trauma, attention should be given to those who may fulfill criteria for a diagnosis of both PTSD and depression.

  1. The effect of flexible cognitive-behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised refugees

    DEFF Research Database (Denmark)

    Buhmann, Caecilie Böck; Nordentoft, Merete; Ekstrøm, Morten

    2016-01-01

    design (registered with Clinicaltrials.gov, NCT00917397, EUDRACT no. 2008-006714-15). Participants were refugees with war-related traumatic experiences, post-traumatic stress disorder (PTSD) and without psychotic disorder. Treatment was weekly sessions with a physician and/or psychologist over 6 months...

  2. Effects of cortisol on cognition in major depressive disorder, posttraumatic stress disorder and borderline personality disorder - 2014 Curt Richter Award Winner.

    Science.gov (United States)

    Wingenfeld, Katja; Wolf, Oliver T

    2015-01-01

    Stress hormones influence a wide range of cognitive functions, including memory performance and executive function. It is well established that glucocorticoids enhance memory consolidation but impair memory retrieval. While most of the effects have been attributed to glucocorticoid receptors (GR), the importance of mineralocorticoid receptors (MR) has been also emphasized. Dysfunctions in hypothalamic-pituitary-adrenal (HPA) axis have been reported for several mental disorders. While major depressive disorder (MDD) as well as borderline personality disorder (BPD) seem to be characterized by enhanced cortisol release in concert with a reduced feedback sensitivity of the HPA axis, in posttraumatic stress disorder (PTSD) a contrary picture has been reported. Despite the fact that altered GR function has been discussed for these disorders only very few studies have investigated the effects of glucocorticoids on cognitive performance in these patients so far. In a series of studies, we investigated the effects of glucocorticoids on cognition (i.e. declarative memory, working memory and response inhibition) in different mental disorders such as MDD, PTSD and BPD. While in patients with MDD cortisol administration failed to effect memory retrieval, patients with PTSD and BPD showed enhanced rather than impaired memory retrieval after cortisol administration. These results indicate an altered sensitivity to cortisol in these disorders. Results from one of our recent studies in the field of social cognition underline the importance of the MR. We found that emotional empathy was enhanced through stimulation of the MR via fludrocortisone in healthy participants and women with BPD. This review aims to integrate these findings and discuss potential mechanisms and implications.

  3. Posttraumatic Stress Disorder and Psychopathology in Dancers.

    Science.gov (United States)

    Thomson, Paula; Jaque, S Victoria

    2015-09-01

    This study investigated the prevalence of posttraumatic stress disorder (PTSD) in pre-professional and professional dancers (n=209) who were exposed to traumatic events. Nine self-report instruments assessed (1) adverse childhood experiences, (2) past traumatic events, (3) coping strategies under stressful situations, and (4) fantasy proneness. The psychopathology variables included (5) anxiety, (6) depression, (7) dissociation, (8) shame, and (9)) PTSD diagnostic scale. Statistical calculations included descriptive, distributional, and multivariate analysis of covariates (MANCOVA). Results indicate that dancers had a significantly higher distribution of PTSD (20.2%) compared to the normal population (7.8%). They also had a higher frequency of family members with mental illness, an inability to speak about their trauma, and more suicidal thoughts. The PTSD group of dancers had higher levels of psychopathology (anxiety, depression, dissociation, and shame) and they had more childhood adversity and adult trauma. Compared to the no-PTSD group, the PTSD group had higher scores on fantasy proneness and emotion-oriented coping strategies. These coping strategies may increase psychological instability. Addressing early abuse and trauma is recommended. Clinicians may help dancers alter their internal working models that their self is worthless, others are abusive, and the world is threatening and dangerous. By understanding PTSD in dancers, medical and mental health treatment protocols may be established to address the debilitating, and often hidden, symptoms of PTSD.

  4. Interpersonal psychotherapy for depression and posttraumatic stress disorder among HIV-positive women in Kisumu, Kenya: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Onu, Chinwe; Ongeri, Linnet; Bukusi, Elizabeth; Cohen, Craig R; Neylan, Thomas C; Oyaro, Patrick; Rota, Grace; Otewa, Faith; Delucchi, Kevin L; Meffert, Susan M

    2016-02-03

    Mental disorders are the leading global cause of years lived with disability; the majority of this burden exists in low and middle income countries (LMICs). Over half of mental illness is attributable to depression and anxiety disorders, both of which have known treatments. While the scarcity of mental health care providers is recognized as a major contributor to the magnitude of untreated disorders in LMICs, studies in LMICs find that evidence-based treatments for depression and anxiety disorders, such as brief, structured psychotherapies, are feasible, acceptable and have strong efficacy when delivered by local non-specialist personnel. However, most mental health treatment studies using non-specialist providers in LMICs deploy traditional efficacy designs (T1) without the benefit of integrated mental health treatment models shown to succeed over vertical interventions or methods derived from new implementation science to speed policy change. Here, we describe an effectiveness-implementation hybrid study that evaluates non-specialist delivery of mental health treatment within an HIV clinic for HIV-positive (HIV+) women affected by gender- based violence (GBV) (HIV+ GBV+) in the Nyanza region of Kenya. In this effectiveness-implementation hybrid type I design, 200 HIV+ women with major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) who are receiving care at a Family AIDS Care Education and Services (FACES)-supported clinic in Kisumu, Kenya will be randomized to: (1) interpersonal psychotherapy (IPT) + treatment as usual (TAU) or (2) TAU, both delivered within the HIV clinic. IPT will consist of 12 weekly 60-minute individual IPT sessions, delivered by non-specialists trained to provide IPT. Primary effectiveness outcomes will include MDD and PTSD diagnosis on the Mini International Diagnostic Interview (MINI). Primary implementation outcomes will include treatment cost-benefit, acceptability, appropriateness, feasibility and fidelity of the

  5. The prevalence of posttraumatic stress among women requesting induced abortion.

    Science.gov (United States)

    Wallin Lundell, Inger; Sundström Poromaa, Inger; Frans, Orjan; Helström, Lotti; Högberg, Ulf; Moby, Lena; Nyberg, Sigrid; Sydsjö, Gunilla; Georgsson Öhman, Susanne; Östlund, Ingrid; Skoog Svanberg, Agneta

    2013-12-01

    To describe the prevalence and pattern of traumatic experiences, to assess the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS), to identify risk factors for PTSD and PTSS, and to analyse the association of PTSD and PTSS with concomitant anxiety and depressive symptoms in women requesting induced abortion. A Swedish multi-centre study of women requesting an induced abortion. The Screen Questionnaire - Posttraumatic Stress Disorder was used for research diagnoses of PTSD and PTSS. Anxiety and depressive symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS). Of the 1514 respondents, almost half reported traumatic experiences. Lifetime- and point prevalence of PTSD were 7% (95% confidence interval [CI]: 5.8-8.5) and 4% (95% CI: 3.1-5.2), respectively. The prevalence of PTSS was 23% (95% CI: 21.1-25.4). Women who reported symptoms of anxiety or depression when requesting abortion were more likely to have ongoing PTSD or PTSS. Also single-living women and smokers displayed higher rates of ongoing PTSD. Although PTSD is rare among women who request an induced abortion, a relatively high proportion suffers from PTSS. Abortion seeking women with trauma experiences and existing or preexisting mental disorders need more consideration and alertness when counselled for termination.

  6. Hopelessness, defeat, and entrapment in posttraumatic stress disorder: their association with suicidal behavior and severity of depression.

    Science.gov (United States)

    Panagioti, Maria; Gooding, Patricia A; Tarrier, Nicholas

    2012-08-01

    Research has shown an increased frequency of suicidal behaviors in those with PTSD, but few studies have investigated the factors that underlie the emergence of suicidal behavior in PTSD. Two theories of suicide, the Cry of Pain and the Schematic Appraisal Model of Suicide, propose that feelings of hopelessness, defeat, and entrapment are core components of suicidality. This study aimed to examine the association between suicidal behavior and hopelessness, defeat, and entrapment in trauma victims with and without a PTSD diagnosis. The results demonstrated that hopelessness, defeat, and entrapment were significantly positively associated with suicidal behavior in those with PTSD. Hopelessness and defeat were also significantly positively associated with suicidal behavior in trauma victims without PTSD. In those with PTSD, the relationship between suicidal behavior and hopelessness and entrapment remained significant after controlling for comorbid depression. The findings provide support for the contemporary theories of suicidality and have important clinical implications.

  7. The psychobiology of posttraumatic stress disorder.

    Science.gov (United States)

    Nutt, D J

    2000-01-01

    Posttraumatic stress disorder (PTSD) develops after exposure to events that are threatening and/or intensely distressing. Accumulating evidence suggests that intense psychological trauma can cause long-standing alterations in the neurobiological response to stress. These alterations translate into a number of symptoms commonly experienced by patients with PTSD. Current treatments for this disorder are only partially effective in managing the disease, and patients have to endure unpleasant symptoms associated with hyperarousal. As a result, they often withdraw from social interaction and increase the use of central nervous system depressants. Data suggest that biological dysregulation of the glutamatergic, amine neurotransmitter (noradrenergic and serotonergic), and neuroendocrine pathways plays a fundamental part in the pathology of PTSD and may cause brain structural as well as functional abnormalities. Knowledge of these pathologic changes in PTSD provides direction for the development of new treatments that will offer more comprehensive management of PTSD and enable patients to enjoy a much improved quality of life. This article reviews current knowledge regarding the psychobiology of PTSD and considers specific agents that are emerging as key modulators of this pathological process.

  8. Brain stimulation in posttraumatic stress disorder.

    Science.gov (United States)

    Novakovic, Vladan; Sher, Leo; Lapidus, Kyle A B; Mindes, Janet; A Golier, Julia; Yehuda, Rachel

    2011-01-01

    Posttraumatic stress disorder (PTSD) is a complex, heterogeneous disorder that develops following trauma and often includes perceptual, cognitive, affective, physiological, and psychological features. PTSD is characterized by hyperarousal, intrusive thoughts, exaggerated startle response, flashbacks, nightmares, sleep disturbances, emotional numbness, and persistent avoidance of trauma-associated stimuli. The efficacy of available treatments for PTSD may result in part from relief of associated depressive and anxiety-related symptoms in addition to treatment of core symptoms that derive from reexperiencing, numbing, and hyperarousal. Diverse, heterogeneous mechanisms of action and the ability to act broadly or very locally may enable brain stimulation devices to address PTSD core symptoms in more targeted ways. To achieve this goal, specific theoretical bases derived from novel, well-designed research protocols will be necessary. Brain stimulation devices include both long-used and new electrical and magnetic devices. Electroconvulsive therapy (ECT) and Cranial electrotherapy stimulation (CES) have both been in use for decades; transcranial magnetic stimulation (TMS), magnetic seizure therapy (MST), deep brain stimulation (DBS), transcranial Direct Current Stimulation (tDCS), and vagus nerve stimulation (VNS) have been developed recently, over approximately the past twenty years. The efficacy of brain stimulation has been demonstrated as a treatment for psychiatric and neurological disorders such as anxiety (CES), depression (ECT, CES, rTMS, VNS, DBS), obsessive-compulsive disorder (OCD) (DBS), essential tremor, dystonia (DBS), epilepsy (DBS, VNS), Parkinson Disease (DBS), pain (CES), and insomnia (CES). To date, limited data on brain stimulation for PTSD offer only modest guidance. ECT has shown some efficacy in reducing comorbid depression in PTSD patients but has not been demonstrated to improve most core PTSD symptoms. CES and VNS have shown some efficacy in

  9. Adolescent Post-Traumatic Stress Disorder

    Science.gov (United States)

    Yule, William

    2003-01-01

    Based on over a decade of work in the area of PTSD, including a longitudinal study of PTSD among adolescents, Dr. Yule provides an introduction to post-traumatic stress disorder as it occurs in youth. This includes a look at the manifestations of stress reactions, the incidence and prevalence of PTSD, and the relationship between levels of…

  10. Posttraumatic stress disorder in survivors of the Brooklyn Bridge shooting.

    Science.gov (United States)

    Trappler, B; Friedman, S

    1996-05-01

    The authors documented the frequency of posttraumatic stress disorder (PTSD) in civilian victims of urban terrorism. A recent shooting attack on a van of Hasidic students provided a unique opportunity to document responses of survivors in this targeted group. Eleven of 14 survivors were compared with age-matched subjects on a variety of questionnaires and clinical evaluations. Of the 11 survivors, four were diagnosed with PTSD (all of whom also had concurrent major depressive disorder), one with major depressive disorder, and two with adjustment disorder. Findings are interpreted in the context of unique factors contributing to the heightened vulnerability of this group.

  11. Posttraumatic stress disorder and completed suicide.

    Science.gov (United States)

    Gradus, Jaimie L; Qin, Ping; Lincoln, Alisa K; Miller, Matthew; Lawler, Elizabeth; Sørensen, Henrik Toft; Lash, Timothy L

    2010-03-15

    Most research regarding posttraumatic stress disorder (PTSD) and suicide has focused on suicidal ideation or attempts; no known study of the association between PTSD and completed suicide in a population-based sample has been reported. This study examined the association between PTSD and completed suicide in a population-based sample. Data were obtained from the nationwide Danish health and administrative registries, which include data on all 5.4 million residents of Denmark. All suicides between January 1, 1994, and December 31, 2006, were included, and controls were selected from a sample of all Danish residents. Using this nested case-control design, the authors examined 9,612 suicide cases and 199,306 controls matched to cases on gender, date of birth, and time. Thirty-eight suicide cases (0.40%) and 95 controls (0.05%) were diagnosed with PTSD. The odds ratio associating PTSD with suicide was 9.8 (95% confidence interval: 6.7, 15). The association between PTSD and completed suicide remained after controlling for psychiatric and demographic confounders (odds ratio = 5.3, 95% confidence interval: 3.4, 8.1). Additionally, persons with PTSD and depression had a greater rate of suicide than expected based on their independent effects. In conclusion, a registry-based diagnosis of PTSD based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, is a risk factor for completed suicide.

  12. The Influence of Depressive Symptoms on Suicidal Ideation Among U.S. Vietnam-Era and Afghanistan/Iraq-Era Veterans with Posttraumatic Stress Disorder

    Science.gov (United States)

    2012-10-01

    Clinical Psychology Review . 2009; 29:727–735.10.1016/j.cpr.2009.08.006 [PubMed: 19744758] Sheehan, DV. The anxiety disease. New York: Scribner; 1983... Psychology Review . 2009; 29:471–482.10.1016/j.cpr.2009.05.001 [PubMed: 19539412] Rudd MD, Goulding J, Bryan CJ. Student veterans: A national survey...160.3.580 [PubMed: 12611845] Panagioti M, Gooding P, Tarrier N. Post-traumatic stress disorder and suicidal behavior: A narrative review. Clinical

  13. Cognitive-Behavior Therapy for Disaster-Exposed Youth with Posttraumatic Stress: Results from a Multiple-Baseline Examination

    Science.gov (United States)

    Taylor, Leslie K.; Weems, Carl F.

    2011-01-01

    Youth traumatized by natural disasters report high levels of posttraumatic stress such as symptoms of posttraumatic stress disorder, other anxiety disorders, and depression. Research suggests that cognitive behavioral therapies are promising interventions for symptom reduction; however, few cognitive behavioral treatments have been systematically…

  14. Social Support, Discrimination, and Coping as Predictors of Posttraumatic Stress Reactions in Youth Survivors of Hurricane Katrina

    Science.gov (United States)

    Pina, Armando A.; Villalta, Ian K.; Ortiz, Claudio D.; Gottschall, Amanda C.; Costa, Natalie M.; Weems, Carl F.

    2008-01-01

    This study examined the influence of aspects of the post-Hurricane Katrina recovery environment (i.e., discrimination, social support) and coping behaviors on children's posttraumatic stress reactions (symptoms of posttraumatic stress disorder [PTSD], anxiety, and depression). Data corresponding to 46 youth (M = 11.43 years; 39% girls; 33% African…

  15. Treatment Practices for Childhood Posttraumatic Stress Disorder.

    Science.gov (United States)

    Cohen, Judith A.; Mannarino, Anthony P.; Rogal, Shari

    2001-01-01

    A survey concerning treatment of children with posttraumatic stress disorder was completed by 77 child psychiatrists and 82 nonmedical therapists. Medical responders reported most preferred treatments included pharmacotherapy, psychodynamic, and cognitive-behavioral therapy. Nonmedical respondents preferred cognitive-behavioral, family, and…

  16. Whiplash and post-traumatic stress disorder

    NARCIS (Netherlands)

    Jaspers, JPC

    1998-01-01

    Purpose : This study examined the comorbidity of whiplash and post-traumatic stress disorder (PTSD) following motor vehicle accidents. A treatment strategy in cases with both disorders is proposed. Method: A review of the literature on psychological consequences of motor vehicle accidents and on ris

  17. Brain stimulation in posttraumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Vladan Novakovic

    2011-10-01

    Full Text Available Posttraumatic stress disorder (PTSD is a complex, heterogeneous disorder that develops following trauma and often includes perceptual, cognitive, affective, physiological, and psychological features. PTSD is characterized by hyperarousal, intrusive thoughts, exaggerated startle response, flashbacks, nightmares, sleep disturbances, emotional numbness, and persistent avoidance of trauma-associated stimuli. The efficacy of available treatments for PTSD may result in part from relief of associated depressive and anxiety-related symptoms in addition to treatment of core symptoms that derive from reexperiencing, numbing, and hyperarousal. Diverse, heterogeneous mechanisms of action and the ability to act broadly or very locally may enable brain stimulation devices to address PTSD core symptoms in more targeted ways. To achieve this goal, specific theoretical bases derived from novel, well-designed research protocols will be necessary. Brain stimulation devices include both long-used and new electrical and magnetic devices. Electroconvulsive therapy (ECT and Cranial electrotherapy stimulation (CES have both been in use for decades; transcranial magnetic stimulation (TMS, magnetic seizure therapy (MST, deep brain stimulation (DBS, transcranial Direct Current Stimulation (tDCS, and vagus nerve stimulation (VNS have been developed recently, over approximately the past twenty years. The efficacy of brain stimulation has been demonstrated as a treatment for psychiatric and neurological disorders such as anxiety (CES, depression (ECT, CES, rTMS, VNS, DBS, obsessive-compulsive disorder (OCD (DBS, essential tremor, dystonia (DBS, epilepsy (DBS, VNS, Parkinson Disease (DBS, pain (CES, and insomnia (CES. To date, limited data on brain stimulation for PTSD offer only modest guidance. ECT has shown some efficacy in reducing comorbid depression in PTSD patients but has not been demonstrated to improve most core PTSD symptoms. CES and VNS have shown some efficacy in

  18. Posttraumatic and depressive symptoms in β-endorphin dynamics.

    Science.gov (United States)

    Savic, Danka; Knezevic, Goran; Matic, Gordana; Damjanovic, Svetozar; Spiric, Zeljko

    2015-08-01

    A disturbed beta-endorphin system can be a part of the post-traumatic stress disorder (PTSD) and depression allostasis. Study subjects (N=392) included those with PTSD and/or (stress-induced) depression, and healthy controls with and without traumas. The aim of the study was to examine the network of relations centered around plasma beta-endorphin. The network included anxiety (as a personality trait), traumatic events, pain, aggressiveness, depressive symptoms, and three clusters of PTSD symptoms: intrusions, avoidance, and hyperarousal. Beta-endorphin was represented by individual mean from 13 time points (BEmean), reflecting the total amount of the peripherally secreted hormone, and the coefficient of variation (BEvar), calculated as the ratio of standard deviation to the mean, reflecting the hormone׳s dynamics. BEvar correlated with all other variables, BEmean had no correlations. Structural equation modeling (SEM) was used to examine all interrelations (including their directions) of BEvar and the state/trait variables in the context of their entirety. The model revealed that hyperarousal and anxiety were the only direct agents of peripheral beta-endorphin fluctuations, mediating the effects of other variables. Traumatic events and intrusions act on BEvar via hyperarousal, while depressive symptoms, avoidance, and pain act via anxiety. Hyperarousal should be emphasized as the main agent not only because its effect on BEvar is larger than that of anxiety, but also because it increases anxiety itself (via avoidance and pain). All influences on BEvar are positive and they indicate long-term (sensitizing) effects (as opposed to direct stimulation, for example, by acute pain, anger, etc.). Relations apart from beta-endorphin are also discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. A pilot study on peritraumatic dissociation and coping styles as risk factors for posttraumatic stress, anxiety and depression in parents after their child's unexpected admission to a Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Last Bob F

    2009-10-01

    Full Text Available Abstract Aim To study the prevalence of posttraumatic stress disorder (PTSD, anxiety and depression in parents three months after pediatric intensive care treatment of their child and examine if peritraumatic dissocation and coping styles are related to these mental health problems. Methods This is a prospective cohort study and included parents of children unexpectedly admitted to the Pediatric Intensive Care Unit (PICU from January 2006 to March 2007. At three months follow-up parents completed PTSD (n = 115, anxiety and depression (n = 128 questionnaires. Immediately after discharge, parents completed peritraumatic dissocation and coping questionnaires. Linear regression models with generalized estimating equations examined risk factors for mental health problems. Results Over 10% of the parents were likely to meet criteria for PTSD and almost one quarter for subclinical PTSD. Respectively 15% to 23% of the parents reported clinically significant levels of depression and anxiety. Peritraumatic dissocation was most strongly associated with PTSD, anxiety as well as depression. Avoidance coping was primarily associated with PTSD. Conclusion A significant number of parents have mental health problems three months after unexpected PICU treatment of their child. Improving detection and raise awareness of mental health problems is important to minimize the negative effect of these problems on parents' well-being.

  20. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So

  1. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So fa

  2. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So fa

  3. Posttraumatic Stress Disorder: Emerging Concepts of Pharmacotherapy

    OpenAIRE

    Baker, Dewleen G.; Nievergelt, Caroline M.; Risbrough, Victoria B.

    2009-01-01

    Posttraumatic stress disorder (PTSD) can result from a traumatic experience that elicits emotions of fear, helpless or horror. Most individuals remain asymptomatic or symptoms quickly resolve, but in a minority intrusive imagery and nightmares, emotional numbing and avoidance, and hyperarousal persist for decades. PTSD is associated with psychiatric and medical co-morbidities, increased risk for suicide, and with poor social and occupational functioning. Psychotherapy and pharmacotherapy are ...

  4. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy.

    Science.gov (United States)

    Hauer, Beatrijs J A; Wessel, Ineke; Engelhard, Iris M; Peeters, Louis L; Dalgleish, Tim

    2009-07-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So far, no reported studies have tested the predictive value of memory specificity at the onset of a potentially traumatic situation. Therefore the aim of the present study was to investigate whether prenatal memory specificity would predict post-traumatic stress after complicated pregnancy. The results demonstrate that women who retrieved fewer specific memories with a pregnancy-related content to positive cues during pregnancy (i.e., directly after hospitalisation) reported more post-traumatic stress 6 weeks after giving birth. This relationship remained significant after controlling for variables that were related to both baseline autobiographical memory specificity and later post-traumatic stress. A similar pattern was found for depression symptomatology, even when somatic symptoms were excluded from the analyses. Taken together, these data suggest that the relationship of memory specificity with later depression can be generalised to post-traumatic stress symptoms.

  5. Posttraumatic Stress Disorder Patients and Results of Violent Behavior

    Directory of Open Access Journals (Sweden)

    Taner Oznur

    2014-08-01

    stress disorder associated with high levels of anger and aggression and alcohol can cause familial-marital problems, breaking up a family, increase in judicial problems and arrest, increase in ratios of self-mutilation and severe bodily injuries, physical violence to patterns and children, progressing of post-traumatic stress disorder, severe mental situations such as depression and suicide. For these reasons, careful detecting of alcohol-drug abuse and overstimulation symptoms as anger/aggression in post-traumatic stress disorder, and rapid target-driven psychopharmacologic and psychotherapeutic interventions Become more of an issue. [TAF Prev Med Bull 2014; 13(4.000: 301-306

  6. Trauma-exposed firefighters: relationships among posttraumatic growth, posttraumatic stress, resource availability, coping and critical incident stress debriefing experience.

    Science.gov (United States)

    Sattler, David N; Boyd, Bill; Kirsch, Julie

    2014-12-01

    This project examines protective factors associated with resilience/posttraumatic growth and risk factors associated with posttraumatic stress among firefighters exposed to critical incidents. The participants were 286 (257 men and 29 women) volunteer and paid firefighters in Whatcom County, Washington. Participants completed an anonymous survey asking about demographics, critical incident exposure, posttraumatic stress symptoms, posttraumatic growth, resource availability, coping, occupational stress and critical incident stress debriefing experience. Most participants had significant critical incident exposure, and about half had attended critical incident stress debriefing sessions. Posttraumatic growth was associated with being female, critical incident exposure, critical incident stress debriefing attendance, posttraumatic stress symptoms (negative association), occupational support, occupation satisfaction, occupational effort, problem-focused coping, emotion-focused coping and personal characteristic resources. Posttraumatic stress symptoms were positively associated with years of firefighting, burnout, occupational effort and disengagement coping and negatively associated with critical incident stress debriefing attendance, posttraumatic growth, social support, internal locus of control, personal characteristic resources, energy resources and condition resources. The findings support conservation of resources stress theory and show that the maintenance and acquisition of resources can offset losses and facilitate resilience/posttraumatic growth. Implications of the findings for enhancing firefighter resources, facilitating resilience and minimizing occupational stressors are discussed. © 2014 John Wiley & Sons, Ltd.

  7. Brief narrative exposure therapy for posttraumatic stress in Iraqi refugees: a preliminary randomized clinical trial.

    Science.gov (United States)

    Hijazi, Alaa M; Lumley, Mark A; Ziadni, Maisa S; Haddad, Luay; Rapport, Lisa J; Arnetz, Bengt B

    2014-06-01

    Many Iraqi refugees suffer from posttraumatic stress. Efficient, culturally sensitive interventions are needed, and so we adapted narrative exposure therapy into a brief version (brief NET) and tested its effects in a sample of traumatized Iraqi refugees. Iraqi refugees in the United States reporting elevated posttraumatic stress (N = 63) were randomized to brief NET or waitlist control conditions in a 2:1 ratio; brief NET was 3 sessions, conducted individually, in Arabic. Positive indicators (posttraumatic growth and well-being) and symptoms (posttraumatic stress, depressive, and somatic) were assessed at baseline and 2- and 4-month follow-up. Treatment participation (95.1% completion) and study retention (98.4% provided follow-up data) were very high. Significant condition by time interactions showed that those receiving brief NET had greater posttraumatic growth (d = 0.83) and well-being (d = 0.54) through 4 months than controls. Brief NET reduced symptoms of posttraumatic stress (d = -0.48) and depression (d = -0.46) more, but only at 2 months; symptoms of controls also decreased from 2 to 4 months, eliminating condition differences at 4 months. Three sessions of brief NET increased growth and well-being and led to symptom reduction in highly traumatized Iraqi refugees. This preliminary study suggests that brief NET is both acceptable and potentially efficacious in traumatized Iraqi refugees.

  8. Symptoms of Posttraumatic Stress after Intensive Care Delirium

    DEFF Research Database (Denmark)

    Svenningsen, Helle; Egerod, Ingrid; Christensen, Doris

    2015-01-01

    Introduction. Long-term psychological consequences of critical illness are receiving more attention in recent years. The aim of our study was to assess the correlation of ICU-delirium and symptoms of posttraumatic stress disorder (PTSD) anxiety and depression after ICU-discharge in a Danish cohort...... in the ICU and symptoms of PTSD in 8% (2 months) and 6% (6 months) after ICU-discharge. Recall of ICU stay was present in 93%. Associations between ICU-delirium and post-discharge PTSD-symptoms were weak and insignificant. Memories of delusions were significantly associated with anxiety after two months....... Remaining associations between types of ICU-memories and prevalence of post-discharge symptoms of PTSD, anxiety, and depression were insignificant after adjusting for age. Incidence of ICU-delirium was unaffected by preadmission use of psychotropic drugs. Prevalence of PTSD-symptoms was unaffected by use...

  9. Symptoms of posttraumatic stress after intensive care delirium

    DEFF Research Database (Denmark)

    Svenningsen, Helle; Egerod, Ingrid; Christensen, Doris;

    2015-01-01

    Introduction. Long-term psychological consequences of critical illness are receiving more attention in recent years. The aim of our study was to assess the correlation of ICU-delirium and symptoms of posttraumatic stress disorder (PTSD) anxiety and depression after ICU-discharge in a Danish cohort...... and symptoms of PTSD in 8% (2 months) and 6% (6 months) after ICU-discharge. Recall of ICU stay was present in 93%. Associations between ICU-delirium and post-discharge PTSD-symptoms were weak and insignificant. Memories of delusions were significantly associated with anxiety after two months. Remaining...... associations between types of ICU-memories and prevalence of post-discharge symptoms of PTSD, anxiety, and depression were insignificant after adjusting for age. Incidence of ICU-delirium was unaffected by preadmission use of psychotropic drugs. Prevalence of PTSD-symptoms was unaffected by use...

  10. Pathways to suicidal behavior in posttraumatic stress disorder.

    Science.gov (United States)

    Panagioti, Maria; Gooding, Patricia A; Dunn, Graham; Tarrier, Nicholas

    2011-04-01

    This study investigated paths to suicidal behavior in 94 civilian participants with chronic posttraumatic stress disorder (PTSD). Two statistical modeling programs, TETRAD II version 2.1 and Mplus 5.21 were used to construct a working model of suicide in PTSD. Two paths to suicidal behavior were identified. In the first path, suicidal behavior was directly associated with greater life impairment, which in turn was associated with poorer occupational and social functioning. In the second path, suicidal behavior was directly associated with depressive symptoms, which in turn were associated with more severe PTSD symptoms. Psychotropic medication, employment status, and threat to life further contributed to the model. The findings suggest that negative perceptions of functional impairment and depression are strongly associated with suicidal behavior in PTSD.

  11. Reiki: Application as a Modality of Integrative Therapy for Treating Post-Traumatic Stress Disorder and Other Wounded Warrior Issues

    Science.gov (United States)

    2015-02-17

    SUPPLEMENTARY NOTES 14. ABSTRACT Post-Traumatic Stress Disorder (PTSD) and suicides are on the rise in our military. After more than a decade of war, a large...Lanoy is also a Reiki Master. Abstract Post-Traumatic Stress Disorder (PTSD) and suicides are on the rise in our military. After more than a...pain, stress , depression, chronic fatigue syndrome, orthopedic conditions, anxiety and overall well-being. Much of the analysis has been done in regard

  12. Posttraumatic Stress Disorder, obesity, and weight loss

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

    -symptoms would decrease as a result of weight loss in obese participants during a 16 week stay at a weight loss facility. During the 16 weeks participants’ Body Mass Index (BMI) decreased significantly. Concurrently, a significant decline in the level of PTSD symptoms was also reported. During the first week......Posttraumatic Stress Disorder (PTSD) has frequently been found to have an impact on the development of obesity, with the relationship between past traumatic episodes and obesity usually thought of as uni-directional. The purpose of the present study was to examine whether the level of PTSD...

  13. Epigenetic Aspects of Posttraumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Ulrike Schmidt

    2011-01-01

    Full Text Available Development of psychiatric diseases such as posttraumatic stress disorder (PTSD invokes, as with most complex diseases, both genetic and environmental factors. The era of genome-wide high throughput technologies has sparked the initiation of genotype screenings in large cohorts of diseased and control individuals, but had limited success in identification of disease causing genetic variants. It has become evident that these efforts at the genomic level need to be complemented with endeavours in elucidating the proteome, transcriptome and epigenetic profiles. Epigenetics is attractive in particular because there is accumulating evidence that the lasting impact of adverse life events is reflected in certain covalent modifications of the chromatin.

  14. Late-onset posttraumatic stress disorder.

    Science.gov (United States)

    Snyder, Marsha

    2008-11-01

    Posttraumatic stress disorder (PTSD) is a complex psychological response to a perceived life-threatening trauma that includes re-experiencing the trauma, avoidance, intrusive thoughts, hyperarousal, and dissociation. Exposure to trauma in early adulthood increases the potential for further psychological threats throughout life. In older adult populations, PTSD is an underrecognized and undertreated disorder that can result in psychosocial disability, substance use, and other negative health outcomes. This article examines the range of symptoms related to PTSD in older adults and expands on health care provider sensitivity to the interrelationship of mental and physical health when addressing the needs of older adults with this disorder.

  15. CAM and Post-Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Alex Hankey

    2007-01-01

    Full Text Available In the form of the Transcendental Meditation program CAM offers a method of eliminating deep-rooted stress, the efficacy of which has been demonstrated in several related studies. Any discussion of CAM and post-traumatic stress disorder should include a study of its application to Vietnam War Veterans in which improvements were observed on all variables, and several participants were able to return to work after several years of being unable to hold a job. The intervention has been studied for its impact on brain and autonomic nervous system function. It has been found to be highly effective against other stress-related conditions such as hypertension, and to improve brain coherence—a measure of effective brain function. It should be considered a possible ‘new and improved mode of treatment’ for PTSD, and further studies of its application made.

  16. Family functioning and mental health in runaway youth: association with posttraumatic stress symptoms.

    Science.gov (United States)

    Thompson, Sanna J; Cochran, Gerald; Barczyk, Amanda N

    2012-10-01

    This study examined the direct effects of physical and sexual abuse, neglect, poor family communication and worries concerning family relationships, depression, anxiety, and dissociation on posttraumatic stress symptoms. Runaway youth were recruited from emergency youth shelters in New York and Texas. Interviews were completed with 350 youth who averaged 15 years of age. Structural equation modeling was used to examine family functioning, maltreatment, depression, dissociation, and anxiety in relation to posttraumatic stress symptoms. Results indicated that direct effects of family relationship worry to dissociation, β = .77, p family communication and youth dissociation, β = .42, p stress symptoms, but depression was not. Findings underscore the critical role of family relationships in mental health symptoms experienced by runaway adolescents. Copyright © 2012 International Society for Traumatic Stress Studies.

  17. Psychological Abuse and Posttraumatic Stress Symptoms in College Students

    Science.gov (United States)

    Avant, Elizabeth M.; Swopes, Rachel M.; Davis, Joanne L.; Elhai, Jon D.

    2011-01-01

    Research suggests that among college students, physical and sexual abuse in intimate relationships are associated with posttraumatic stress. Psychological abuse occurs in intimate relationships among college students, and though there is evidence that such abuse has a negative emotional impact, posttraumatic stress has not been extensively…

  18. Exposure to Political Conflict and Violence and Posttraumatic Stress in Middle East Youth: Protective Factors

    Science.gov (United States)

    Dubow, Eric F.; Huesmann, L. Rowell; Boxer, Paul; Landau, Simha; Dvir, Shira; Shikaki, Khalil; Ginges, Jeremy

    2012-01-01

    We examine the role of family- and individual-level protective factors in the relation between exposure to ethnic-political conflict and violence and posttraumatic stress among Israeli and Palestinian youth. Specifically, we examine whether parental mental health (lack of depression), positive parenting, children's self-esteem, and academic…

  19. Acceptance and Commitment Therapy for Treatment-Resistant Posttraumatic Stress Disorder: A Case Study

    Science.gov (United States)

    Twohig, Michael P.

    2009-01-01

    An adult woman with chronic posttraumatic stress disorder (PTSD) and major depressive disorder who was nonresponsive to 20 sessions of cognitive behavior therapy (CBT) is presented in this case study. Two months after her CBT trial, she was treated with 21 sessions of Acceptance and Commitment Therapy (ACT) for PTSD. Measurements of PTSD severity,…

  20. Acceptance and Commitment Therapy for Treatment-Resistant Posttraumatic Stress Disorder: A Case Study

    Science.gov (United States)

    Twohig, Michael P.

    2009-01-01

    An adult woman with chronic posttraumatic stress disorder (PTSD) and major depressive disorder who was nonresponsive to 20 sessions of cognitive behavior therapy (CBT) is presented in this case study. Two months after her CBT trial, she was treated with 21 sessions of Acceptance and Commitment Therapy (ACT) for PTSD. Measurements of PTSD severity,…

  1. The Relationship between Posttraumatic Stress Symptomatology and Suicidal Behavior in School-based Adolescents.

    Science.gov (United States)

    Mazza, James J.

    2000-01-01

    Investigates the relationship between posttraumatic stress disorder (PTSD) symptomatology and suicidal behavior, specifically suicidal ideation and suicide attempt history, while controlling for depression and gender in 106 adolescents in an urban high school. PTSD symptomatology was significantly related to suicidal ideation and showed a trend…

  2. The Comorbidity of Post-traumatic Stress Disorder and Suicidality in Vietnam Veterans.

    Science.gov (United States)

    Kramer, Teresa L.; And Others

    1994-01-01

    Assessed 232 Vietnam veterans for suicidal thinking and behaviors and symptoms of posttraumatic stress disorder and depression. Findings support notion that suicidal thoughts are prevalent in this group, with veterans in psychotherapy reporting greater likelihood of such symptoms than veterans in community or those seeking assistance through…

  3. Association between flashbacks and structural brain abnormalities in posttraumatic stress disorder

    NARCIS (Netherlands)

    Kroes, M.C.W.; Whalley, M.G.; Rugg, M.D.; Brewin, C.R.

    2011-01-01

    OBJECTIVE: Posttraumatic stress disorder (PTSD) is reliably associated with reduced brain volume relative to healthy controls, in areas similar to those found in depression. We investigated whether in a PTSD sample brain volumes in these areas were related to reporting specific symptoms of PTSD or t

  4. Exposure to Political Conflict and Violence and Posttraumatic Stress in Middle East Youth: Protective Factors

    Science.gov (United States)

    Dubow, Eric F.; Huesmann, L. Rowell; Boxer, Paul; Landau, Simha; Dvir, Shira; Shikaki, Khalil; Ginges, Jeremy

    2012-01-01

    We examine the role of family- and individual-level protective factors in the relation between exposure to ethnic-political conflict and violence and posttraumatic stress among Israeli and Palestinian youth. Specifically, we examine whether parental mental health (lack of depression), positive parenting, children's self-esteem, and academic…

  5. [Posttraumatic stress state: a therapeutic lever].

    Science.gov (United States)

    Waddington, A; Zeltner, L; Robin, M; Mauriac, F; Ampelas, J-F; Bronchard, M; Mallat, V

    2004-01-01

    Chronic post-traumatic stress disorder (PTSD) is a very complex syndrome which is hard to detect because of the multiplicity of its expressions. Further more, these clinical expressions are far from the "pure" syndrome described in the DSM IV. So, the clinician faces a dilemma: how can he account for the traumatic clues without using the PTSD as a ragbag of a diagnosis? We found the way to discard this dilemma when we decided to use what M. Struber said about her experience with cancer and PTSD. She suggests not to emphasize psychopathology and to use a post-traumatic stress framework. This way to reframe some psychiatric urgencies is very useful because it gives back ability to the patient. When using a post-traumatic stress framework we tell the patient and his family that we acknowledge he has defensible reasons for not managing with an event which, we acknowledge too, was traumatic for him. In that way we begin to explore what each person is experiencing, because the traumatic experiencing is generally shared by the patient and his family. The members of the family are often angry and fed up of the patient behaviour and think themselves as victims of him. On the other part, the patient feels himself as a misunderstood person, victim of the others. The primary trauma is forgotten for a long time or nobody make any link between it and what is happening in the present. The manifestations of the PTSD initiate subsequent aftermaths and suffering for everybody. When working with psychiatric emergencies, we have to manage with acute situations in which each people is both victim and aggressor and in which clinicians run the risk of being given the role of either victim or aggressor. The trial of strength played between the patient and his family is going to be played with the clinician. These situations are described by S. Lamarre when she speaks of "victimisation" and are overloaded with control stake. Each one tries to make the other guilty and disgraced, and the

  6. [The post-traumatic stress disorder].

    Science.gov (United States)

    Olff, Miranda

    2013-01-01

    Many people experience a potentially traumatic event during their lives, which can result in brief periods of post-traumatic stress symptoms; this is a normal reaction. Most people can deal with a traumatic event when supported by significant others, but 10% of them develop post-traumatic stress disorder (PTSD). The nature of the traumatic event, the duration of exposure and the age at which one experiences such an event partly determine whether a person will develop PTSD. Psychological debriefing (a single-session consultation) does not prevent the development of PTSD; it is therefore not useful to offer this to everyone who has experienced a traumatic event. New and promising developments have, however, arisen in this regard. Trauma-focused psychotherapy has proved to be effective for patients with PTSD, possibly in combination with medication. Individuals who experience many or severe initial symptoms after a traumatic event may benefit from early, short-term, trauma-focused psychotherapy for preventing the development of chronic PTSD. Developments pertaining to the DSM-5 pay more attention to 'complex' PTSD, a type which is often the result of long-term traumatisation during childhood.

  7. Trait Resilience Moderates the Longitudinal Linkage between Adolescent Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth

    Science.gov (United States)

    Ying, Liuhua; Wang, Yanli; Lin, Chongde; Chen, Chuansheng

    2016-01-01

    The current study examined the longitudinal association between posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) as well as the moderating role of trait resilience in that association. Participants completed measures of PTSD symptoms, PTG, and trait resilience at 12, 18, and 24 months after the Wenchuan earthquake.…

  8. Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: a cross-sectional study.

    Science.gov (United States)

    Sakuma, Atsushi; Takahashi, Yoko; Ueda, Ikki; Sato, Hirotoshi; Katsura, Masahiro; Abe, Mikika; Nagao, Ayami; Suzuki, Yuriko; Kakizaki, Masako; Tsuji, Ichiro; Matsuoka, Hiroo; Matsumoto, Kazunori

    2015-03-24

    Many local workers have been involved in rescue and reconstruction duties since the Great East Japan Earthquake (GEJE) on March 11, 2011. These workers continuously confront diverse stressors as both survivors and relief and reconstruction workers. However, little is known about the psychological sequelae among these workers. Thus, we assessed the prevalence of and personal/workplace risk factors for probable post-traumatic stress disorder (PTSD), probable depression, and high general psychological distress in this population. Participants (N = 1294; overall response rate, 82.9%) were workers (firefighters, n = 327; local municipality workers, n = 610; hospital medical workers, n = 357) in coastal areas of Miyagi prefecture. The study was cross-sectional and conducted 14 months after the GEJE using a self-administered questionnaire which included the PTSD Checklist-Specific Version, the Patient Health Questionnaire-9, and the K6 scale. Significant risk factors from bivariate analysis, such as displacement, dead or missing family member(s), near-death experience, disaster related work, lack of communication, and lack of rest were considered potential factors in probable PTSD, probable depression, and high general psychological distress, and were entered into the multivariable logistic regression model. The prevalence of probable PTSD, probable depression, and high general psychological distress was higher among municipality (6.6%, 15.9%, and 14.9%, respectively) and medical (6.6%, 14.3%, and 14.5%, respectively) workers than among firefighters (1.6%, 3.8%, and 2.6%, respectively). Lack of rest was associated with increased risk of PTSD and depression in municipality and medical workers; lack of communication was linked to increased PTSD risk in medical workers and depression in municipality and medical workers; and involvement in disaster-related work was associated with increased PTSD and depression risk in municipality workers. The present results

  9. Childhood abuse history, posttraumatic stress disorder, postpartum mental health and bonding: A prospective cohort study

    Science.gov (United States)

    Seng, Julia S.; Sperlich, Mickey; Low, Lisa Kane; Ronis, David L.; Muzik, Maria; Liberzon, Israel

    2012-01-01

    Introduction Research is needed that prospectively characterizes the intergenerational pattern of effects of childhood maltreatment and lifetime posttraumatic stress disorder (PTSD) on women’s mental health in pregnancy and on postpartum mental health and bonding outcomes. This prospective study included 566 nulliparous women in 3 cohorts: PTSD-positive, trauma-exposed resilient, and non-exposed to trauma. Methods Standardized telephone interviews with women who were less than 28 gestational weeks ascertained trauma history, PTSD diagnosis, and depression diagnosis. A six-week postpartum interview reassessed interim trauma, labor experience, PTSD, depression, and bonding outcomes. Results Regression modeling indicates posttraumatic stress in pregnancy, alone, or comorbid with depression, is associated with postpartum depression (R2=.204, P<.001). Postpartum depression alone, or comorbid with posttraumatic stress, was associated with impaired bonding (R2=.195, P<.001). In both models, higher quality of life ratings in pregnancy were associated with better outcomes, while reported dissociation in labor was a risk for worse outcomes. The effect of a history of childhood maltreatment on both postpartum mental health and bonding outcomes was mediated by pre-existing mental health status. Discussion Pregnancy represents an opportune time to interrupt the pattern of intergenerational transmission of abuse and psychiatric vulnerability. Further dyadic research is warranted beyond six weeks postpartum. Trauma-informed interventions for women who enter care with abuse-related PTSD or depression should be developed and tested. PMID:23374491

  10. Sex differences in objective measures of sleep in post-traumatic stress disorder and healthy control subjects.

    Science.gov (United States)

    Richards, Anne; Metzler, Thomas J; Ruoff, Leslie M; Inslicht, Sabra S; Rao, Madhu; Talbot, Lisa S; Neylan, Thomas C

    2013-12-01

    A growing literature shows prominent sex effects for risk for post-traumatic stress disorder and associated medical comorbid burden. Previous research indicates that post-traumatic stress disorder is associated with reduced slow wave sleep, which may have implications for overall health, and abnormalities in rapid eye movement sleep, which have been implicated in specific post-traumatic stress disorder symptoms, but most research has been conducted in male subjects. We therefore sought to compare objective measures of sleep in male and female post-traumatic stress disorder subjects with age- and sex-matched control subjects. We used a cross-sectional, 2 × 2 design (post-traumatic stress disorder/control × female/male) involving83 medically healthy, non-medicated adults aged 19-39 years in the inpatient sleep laboratory. Visual electroencephalographic analysis demonstrated that post-traumatic stress disorder was associated with lower slow wave sleep duration (F(3,82)  = 7.63, P = 0.007) and slow wave sleep percentage (F(3,82)  = 6.11, P = 0.016). There was also a group × sex interaction effect for rapid eye movement sleep duration (F(3,82)  = 4.08, P = 0.047) and rapid eye movement sleep percentage (F(3,82)  = 4.30, P = 0.041), explained by greater rapid eye movement sleep in post-traumatic stress disorder females compared to control females, a difference not seen in male subjects. Quantitative electroencephalography analysis demonstrated that post-traumatic stress disorder was associated with lower energy in the delta spectrum (F(3,82)  = 6.79, P = 0.011) in non-rapid eye movement sleep. Slow wave sleep and delta findings were more pronounced in males. Removal of post-traumatic stress disorder subjects with comorbid major depressive disorder, who had greater post-traumatic stress disorder severity, strengthened delta effects but reduced rapid eye movement effects to non-significance. These findings support previous evidence that post-traumatic

  11. Factors associated with posttraumatic stress symptoms in a prospective cohort of patients after abdominal sepsis: A nomogram

    NARCIS (Netherlands)

    Boer, K.R.; van Ruler, O.; van Emmerik, A.A.P.; Sprangers, M.A.; de Rooij, S.E.; Vroom, M.B.; de Borgie, C.A.J.M.; Boermeester, M.A.; Reitsma, J.B.

    2008-01-01

    Objective: To determine to what extent patients who have survived abdominal sepsis suffer from symptoms of posttraumatic stress disorder (PTSD) and depression, and to identify potential risk factors for PTSD symptoms. Design and setting: PTSD and depression symptoms were measured using the Impact of

  12. Stress, externality, and depression.

    Science.gov (United States)

    Ganellen, R J; Blaney, P H

    1984-12-01

    Previous research has found mixed support for the possibility that locus of control moderates the effects of life stress on depression. Two methodological choices may have influenced previous findings: the use of a unidimensional rather than a multidimensional locus of control scale, and reliance on linear statistical methods using median splits. We attempted to correct these choices by using the Levenson IPC scale (1974) and multiple regression analyses in a female undergraduate population (N = 158). The results supported use of a multidimensional scale, since Stress, Internality, and Powerful Others were found to have main effects on depression whereas Chance interacted with life stress. The question of whether locus of control refers to responsibility for causing an event, i.e., self-blame, or belief in control over future events, i.e., coping behavior, was discussed.

  13. Biological Studies of Posttraumatic Stress Disorder

    Science.gov (United States)

    Pitman, Roger K.; Rasmusson, Ann M.; Koenen, Karestan C.; Shin, Lisa M.; Orr, Scott P.; Gilbertson, Mark W.; Milad, Mohammed R.; Liberzon, Israel

    2016-01-01

    Preface Posttraumatic stress disorder (PTSD) is the only major mental disorder for which a cause is considered to be known, viz., an event that involves threat to the physical integrity of oneself or others and induces a response of intense fear, helplessness, or horror. Although PTSD is still largely regarded as a psychological phenomenon, over the past three decades the growth of the biological PTSD literature has been explosive, and thousands of references now exist. Ultimately, the impact of an environmental event, such as a psychological trauma, must be understood at organic, cellular, and molecular levels. The present review attempts to present the current state of this understanding, based upon psychophysiological, structural and functional neuroimaging, endocrinological, genetic, and molecular biological studies in humans and in animal models. PMID:23047775

  14. Posttraumatic stress in immigrants from Central America and Mexico.

    Science.gov (United States)

    Cervantes, R C; Salgado de Snyder, V N; Padilla, A M

    1989-06-01

    International migration has been associated with increased levels of psychological disturbance, particularly among refugees who have fled from war or political unrest. This study examined self-reported symptoms of depression, anxiety, somatization, generalized distress, and posttraumatic stress disorder (PTSD) in a community sample of 258 immigrants from Central America and Mexico and 329 native-born Mexican Americans and Anglo Americans. Immigrants were found to have higher levels of generalized distress than native-born Americans. Fifty-two percent of Central American immigrants who migrated as a result of war or political unrest reported symptoms consistent with a diagnosis of PTSD, compared with 49 percent of Central Americans who migrated for other reasons and 25 percent of Mexican immigrants. The authors call for more research to document the psychosocial aspects of migration.

  15. Symptoms of Posttraumatic Stress after Intensive Care Delirium

    DEFF Research Database (Denmark)

    Svenningsen, Helle; Egerod, Ingrid; Christensen, Doris

    2015-01-01

    Introduction. Long-term psychological consequences of critical illness are receiving more attention in recent years. The aim of our study was to assess the correlation of ICU-delirium and symptoms of posttraumatic stress disorder (PTSD) anxiety and depression after ICU-discharge in a Danish cohort....... Methods. A prospective observational cohort study assessing the incidence of delirium in the ICU. Psychometrics were screened by validated tools in structured telephone interviews after 2 months (n = 297) and 6 months (n = 248) after ICU-discharge. Results. Delirium was detected in 54% of patients...... in the ICU and symptoms of PTSD in 8% (2 months) and 6% (6 months) after ICU-discharge. Recall of ICU stay was present in 93%. Associations between ICU-delirium and post-discharge PTSD-symptoms were weak and insignificant. Memories of delusions were significantly associated with anxiety after two months...

  16. Cognitive processes in post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Gamze Yıldırımlı

    2012-11-01

    Full Text Available Post-traumatic Stress disorder (PTSD consists of a pattern of symptoms that include cognitive, affective, sensory and behavioral systems. In PTSD, the individual experiences disturbing emotions and sensations such as anxiety, panic, depression, anger, tension, high startle response and hypervigilance as a result of reexperiencing traumatic memories, flashbacks, attention difficulties, memory loss, nightmares and intrusive thoughts. The cognitive approach asserts that cognitions play a triggering and maintaining role for these symptoms and tries to explain them with the information processing framework. According to this approach, the traumatic event that is experienced is processed differently from daily, ordinary events. This different information processing strategy stands out in attention, memory, dissociation, cognitive beliefs, cognition-affect processes and coping strategies. In the present paper, research on how these constructs that are parts of the information processing in cognitive systems function in PTSD will be reviewed.

  17. Effects of Estradiol on Post-Traumatic Stress Disorder Symptoms

    Science.gov (United States)

    2010-03-01

    glucocorticoid acting via two specific glucocorticoid response elements in the p11 promoter. Neuroscience 2008;153:1126-34. 20. Siegmund A, Wotjak...and chronic restraint stress on visceral sensitivity and neuroendocrine hormones in rats. Chin J Dig Dis 2006;7:149-55. 60. Siegmund A, Wotjak CT...posttraumatic stress disorder. Biol Psychiatry 1993;33:479-86. 60. Siegmund A, Wotjak CT. Toward an animal model of posttraumatic stress disorder

  18. Mind-body practices for posttraumatic stress disorder.

    Science.gov (United States)

    Kim, Sang Hwan; Schneider, Suzanne M; Kravitz, Len; Mermier, Christine; Burge, Mark R

    2013-06-01

    Mind-body practices are increasingly used to provide stress reduction for posttraumatic stress disorder (PTSD). Mind-body practice encompasses activities with the intent to use the mind to impact physical functioning and improve health. This is a literature review using PubMed, PsycINFO, and Published International Literature on Traumatic Stress to identify the effects of mind-body intervention modalities, such as yoga, tai chi, qigong, mindfulness-based stress reduction, meditation, and deep breathing, as interventions for PTSD. The literature search identified 92 articles, only 16 of which were suitable for inclusion in this review. We reviewed only original, full text articles that met the inclusion criteria. Most of the studies have small sample size, but findings from the 16 publications reviewed here suggest that mind-body practices are associated with positive impacts on PTSD symptoms. Mind-body practices incorporate numerous therapeutic effects on stress responses, including reductions in anxiety, depression, and anger, and increases in pain tolerance, self-esteem, energy levels, ability to relax, and ability to cope with stressful situations. In general, mind-body practices were found to be a viable intervention to improve the constellation of PTSD symptoms such as intrusive memories, avoidance, and increased emotional arousal. Mind-body practices are increasingly used in the treatment of PTSD and are associated with positive impacts on stress-induced illnesses such as depression and PTSD in most existing studies. Knowledge about the diverse modalities of mind-body practices may provide clinicians and patients with the opportunity to explore an individualized and effective treatment plan enhanced by mind-body interventions as part of ongoing self-care.

  19. Posttraumatic stress disorder after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Shu-Guang Jin; Lu-Nan Yan; Bo Xiang; Bo Li; Tian-Fu Wen; Ji-Chun Zhao; Ming-Qing Xu; Jia-Ying Yang

    2012-01-01

    BACKGROUND: Liver transplantation can lead to the develop-ment of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liver transplant recipients, a cross-sectional investigation of 296 recipients at our hospital was carried out between January and June 2010. METHODS: Study participants completed two questionnaires [a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36)]. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires. RESULTS: The prevalence of full PTSD and partial PTSD (that met the criteria for 2 of the 3 symptom clusters) was 3.7% and 5.4%, respectively, for all transplant recipients. Significant differences between the recipients with no PTSD, partial PTSD, and full PTSD were found in all SF-36 domains except for physical functioning (P=0.466). In general, domain scores were the highest in the recipients who did not meet the criteria for PTSD and the lowest in the recipients who met the criteria for full PTSD. Greater severity of posttraumatic stress symptoms was correlated with poorer quality of life, especially in the bodily pain (P=0.004), social functioning (P=0.001), role-emotional (P=0.048), and mental health (P<0.001) domains. The model for end-stage liver disease (MELD) scores, complications, and educational status were identified by multiple regression analysis as risk factors for developing PTSD. CONCLUSIONS: PTSD occurred after liver transplantation and was significantly associated with decreased quality of life. Higher MELD scores and complications after transplantation were risk factors that contributed to PTSD, and higher education was a protective factor.

  20. Evaluation of physical activity habits in patients with posttraumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Marcio Antonio de Assis

    2008-01-01

    Full Text Available OBJECTIVE: In this study, we present data from a survey that aimed to assess the physical activity habits of adult Brazilian patients with Posttraumatic Stress Disorder. METHOD: Fifty male and female patients with Posttraumatic Stress Disorder participated in this study. The mean age at onset was 37±12 years, and the mean time between diagnosis and follow-up was 3.6±4.2 years. RESULTS: Substantial changes in physical activity habits were observed following the onset of PTSD. While more than half of the patients participated in physical activities prior to Posttraumatic Stress Disorder onset, there was a significant reduction in their participation afterwards. The justifications for stopping physical activities or sport participation were lack of time and lack of motivation. DISCUSSION: Several studies have shown that physical exercise decreases reverts symptoms of psychiatric disorders such as depression, anxiety and social isolation. We could therefore hypothesize that patients with Posttraumatic Stress Disorder who exercise should experience the same benefits. CONCLUSION: Our findings demonstrated that patients with Posttraumatic Stress Disorder have low levels of participation in sports or physical activities.

  1. Life satisfaction in people with post-traumatic stress disorder.

    Science.gov (United States)

    Karatzias, Thanos; Chouliara, Zoë; Power, Kevin; Brown, Keith; Begum, Millia; McGoldrick, Therese; MacLean, Rory

    2013-12-01

    There is limited research on the association between post-traumatic stress disorder (PTSD) and life satisfaction in community samples. We set out to investigate levels of life satisfaction and its demographic, trauma related and clinical predictors in a sample of people with PTSD (n = 46). Participants completed a battery of standardised self-report measures including Satisfaction with Life Scale, the PTSD Checklist and The Hospital Anxiety and Depression Scale. Our results indicated that people with moderately severe PTSD in the community are likely to experience lower levels of life satisfaction compared with those with other psychiatric conditions or those without any diagnoses. Multivariate analysis revealed that marital status and trauma symptoms were the only significant predictors of life satisfaction. In specific, being married and presenting with less severe posttraumatic symptomatology were both significantly associated with higher levels of life satisfaction in people with PTSD. The strong association between traumatic symptomatology and life satisfaction may indicate that routine assessment for life satisfaction or similar positive constructs in people with PTSD, referred for psychological therapies might be useful. Information on positive psychology constructs may facilitate capitalising on clients' strengths and not just on pathology.

  2. Suicidal behavior in adolescents with post-traumatic stress disorder.

    Science.gov (United States)

    Ganz, D; Sher, L

    2010-08-01

    Recently, the prevalence of post-traumatic stress disorder (PTSD) in adolescence is higher than the prevalence of PTSD in adult populations. PTSD and suicidality are often found in populations of adolescents presenting with other emotional disorders (particularly mood disorders), traumatic grief, childhood abuse, and/or a family or peer history of suicide. The reasons and developments of the association between PTSD and suicidality in adolescence, however, remain unclear. Core psychobiological changes contributing to PTSD affect emotion, arousal, perception of the self and the world, irritability, impulsivity, anger, aggression and depression. There is evidence that the aforementioned factors, as well as alcohol and other drug use may act to moderate the influence of stressful life events and lead to eventual suicidality. Both PTSD and suicidality in adolescents have also been hypothesized to be a result of exposure to violence and negative coping styles. There are many treatment challenges for these populations, yet the most promising prevention and treatments include suicide risk screenings, suicide education, Dialectical Behavioral Therapy, addressing associated coping mechanisms and prescribing anti-depressant and anti-anxiety medications. However, when prescribing medications, physicians do need to be careful to consider the weaknesses and strengths of each of the pharmacological options as they apply to adolescents presenting with PTSD and suicidality.

  3. Writing therapy for posttraumatic stress: a meta-analysis

    NARCIS (Netherlands)

    A.A.P. van Emmerik; A. Reijntjes; J.H. Kamphuis

    2012-01-01

    Background: Face-to-face psychological treatments have difficulty meeting today’s growing mental health needs. For the highly prevalent posttraumatic stress (PTS) conditions, accumulating evidence suggests that writing therapy may constitute an efficient treatment modality, especially when administe

  4. Writing therapy for posttraumatic stress: a meta-analysis

    NARCIS (Netherlands)

    van Emmerik, A.A.P.; Reijntjes, A.; Kamphuis, J.H.

    2013-01-01

    Background: Face-to-face psychological treatments have difficulty meeting today’s growing mental health needs. For the highly prevalent posttraumatic stress (PTS) conditions, accumulating evidence suggests that writing therapy may constitute an efficient treatment modality, especially when administe

  5. Update on the management of post-traumatic stress disorder.

    Science.gov (United States)

    Wallace, Duncan; Cooper, John

    2015-04-01

    Post-traumatic stress disorder occurs in people exposed to life-threatening trauma. GPs may be seeing more patients with post-traumatic stress disorder as military personnel return from overseas deployments. The condition can present in various ways. To reduce the likelihood of missed or delayed diagnosis GPs can screen at-risk populations. A comprehensive assessment is recommended. Specialist referral may be required, particularly if there are other mental health problems. Trauma-focused psychological therapies should be offered as the first line of treatment for post-traumatic stress disorder. Usually 8-12 sessions are needed for a therapeutic effect. If drug treatment is needed, selective serotonin reuptake inhibitors are the first line. Other drugs used in post-traumatic stress disorder include antipsychotics, anticonvulsants and prazosin.

  6. Neuroimaging genetic approaches to Posttraumatic Stress Disorder.

    Science.gov (United States)

    Lebois, Lauren A M; Wolff, Jonathan D; Ressler, Kerry J

    2016-10-01

    Neuroimaging genetic studies that associate genetic and epigenetic variation with neural activity or structure provide an opportunity to link genes to psychiatric disorders, often before psychopathology is discernable in behavior. Here we review neuroimaging genetics studies with participants who have Posttraumatic Stress Disorder (PTSD). Results show that genes related to the physiological stress response (e.g., glucocorticoid receptor and activity, neuroendocrine release), learning and memory (e.g., plasticity), mood, and pain perception are tied to neural intermediate phenotypes associated with PTSD. These genes are associated with and sometimes predict neural structure and function in areas involved in attention, executive function, memory, decision-making, emotion regulation, salience of potential threats, and pain perception. Evidence suggests these risk polymorphisms and neural intermediate phenotypes are vulnerabilities toward developing PTSD in the aftermath of trauma, or vulnerabilities toward particular symptoms once PTSD has developed. Work distinguishing between the re-experiencing and dissociative sub-types of PTSD, and examining other PTSD symptom clusters in addition to the re-experiencing and hyperarousal symptoms, will further clarify neurobiological mechanisms and inconsistent findings. Furthermore, an exciting possibility is that genetic associations with PTSD may eventually be understood through differential intermediate phenotypes of neural circuit structure and function, possibly underlying the different symptom clusters seen within PTSD. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. EMDR for post-traumatic stress and other psychological trauma.

    Science.gov (United States)

    Norgate, Kath

    Eye movement desensitisation and reprocessing (EMDR) is a powerful psychotherapy with well-researched benefits for adults and children who are experiencing post-traumatic stress and post-traumatic stress disorder. There is a wealth of research and practice-based evidence demonstrating the effectiveness of EMDR in many differing clinical presentations but the true potential of this extraordinarily beneficial therapeutic approach has not been fully embraced by the mental health nursing profession.

  8. Pharmacotherapy of post-traumatic stress disorder.

    Science.gov (United States)

    Opler, Lewis A; Grennan, Michelle S; Opler, Mark G

    2006-12-01

    In the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, DSM-III-R and DSM-IV, the diagnosis of post-traumatic stress disorder (PTSD) requires the presence of three symptom clusters: re-experiencing, avoidance and hyperarousal. The selective serotonin reuptake inhibitors (SSRIs), in particular sertraline and paroxetine, have emerged as the treatment of choice for trauma victims experiencing these three symptom clusters. While not approved by the U.S. Food and Drug Administration, other pharmacological agents are often used, some for symptoms found in victims of early, chronic or extreme stress. Referred to as having type II trauma, complex PTSD, disorders of extreme stress and enduring personality change after catastrophic experience, these patients, with symptoms such as dissociation, somatization and self-injurious behavior, need to be recognized as suffering from a trauma-related disorder qualitatively different from that presently captured in the DSM-IV. In this paper we will refer to DSM-IV's construct as simple PTSD (sPTSD); to complex PTSD/disorders of extreme stress as cPTSD/DES; and to both as PTSD. We will review existing evidence for the efficacy of SSRIs in treating sPTSD as well as different pharmacological interventions that are necessary for the treatment of cPTSD/DES. In addition, since both sPTSD and cPTSD/DES frequently coexist with other mental disorders, treatment of comorbid PTSD will be addressed. Finally, given that existing rating scales are not designed to measure symptoms of cPTSD/DES, we will describe the Symptoms of Trauma Scale (SOTS), designed to measure symptoms of both sPTSD and cPTSD.

  9. Re-emergence of posttraumatic stress disorder nightmares with nursing home admission: treatment with prazosin.

    Science.gov (United States)

    Johnson, Kim G; Rosen, Jules

    2013-02-01

    Seniors with a history of emotional trauma decades earlier can experience a recurrence of posttraumatic stress disorder symptoms when transitioning to a nursing home. We present the case of an 86-year-old male Holocaust survivor admitted to a nursing home for physical therapy and rehabilitation 6 weeks after the death of his wife; the patient was expressing a persistent death wish. Despite the multiple risk factors for depression, his distress was specifically related to the reemergence of nightly posttraumatic nightmares. Over the course of 1 week of treatment with 1 mg prazosin at bedtime, his nightmares and his death wish completely resolved. He achieved his rehabilitation goals and was discharged to a community setting. This report highlights the importance of considering posttraumatic stress disorder in nursing home residents with a history of emotional trauma, and understanding how to address these symptoms pharmacologically and nonpharmacologically.

  10. Response Inhibition and Cognitive Appraisal in Clients with Acute Stress Disorder and Posttraumatic Stress Disorder

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    Abass Abolghasemi

    2013-09-01

    Full Text Available Objective: The purpose of the present study was to compare response inhibition and cognitive appraisal in clients with acute stress disorder, clients with posttraumatic stress disorder, and normal individuals .Method:This was a comparative study. The sample consisted of 40 clients with acute stress disorder, 40 patients with posttraumatic stress disorder, and 40 normal individuals from Mazandaran province selected through convenience sampling method. Data were collected using Composite International Diagnostic Interview, Stroop Color-Word Test, Posttraumatic Cognitions Inventory, and the Impact of Event Scale. Results:Results showed that individuals with acute stress disorder are less able to inhibit inappropriate responses and have more impaired cognitive appraisals compared to those with posttraumatic stress disorder. Moreover, results showed that response inhibition and cognitive appraisal explain 75% of the variance in posttraumatic stress disorder symptoms and 38% of the variance in posttraumatic stress disorder symptoms .Conclusion:The findings suggest that response inhibition and cognitive appraisal are two variables that influence the severity of posttraumatic stress disorder and acute stress disorder symptoms. Also, these results have important implications for pathology, prevention, and treatment of posttraumatic stress disorder and acute stress disorder

  11. Symptoms of Posttraumatic Stress after Intensive Care Delirium

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    Helle Svenningsen

    2015-01-01

    Full Text Available Introduction. Long-term psychological consequences of critical illness are receiving more attention in recent years. The aim of our study was to assess the correlation of ICU-delirium and symptoms of posttraumatic stress disorder (PTSD anxiety and depression after ICU-discharge in a Danish cohort. Methods. A prospective observational cohort study assessing the incidence of delirium in the ICU. Psychometrics were screened by validated tools in structured telephone interviews after 2 months (n=297 and 6 months (n=248 after ICU-discharge. Results. Delirium was detected in 54% of patients in the ICU and symptoms of PTSD in 8% (2 months and 6% (6 months after ICU-discharge. Recall of ICU stay was present in 93%. Associations between ICU-delirium and post-discharge PTSD-symptoms were weak and insignificant. Memories of delusions were significantly associated with anxiety after two months. Remaining associations between types of ICU-memories and prevalence of post-discharge symptoms of PTSD, anxiety, and depression were insignificant after adjusting for age. Incidence of ICU-delirium was unaffected by preadmission use of psychotropic drugs. Prevalence of PTSD-symptoms was unaffected by use of antipsychotics and sedation in the ICU. Conclusion. ICU-delirium did not increase the risk of PTSD-symptoms at 2 and 6 months after ICU discharge.

  12. Writing therapy for posttraumatic stress: a meta-analysis.

    Science.gov (United States)

    van Emmerik, Arnold A P; Reijntjes, Albert; Kamphuis, Jan H

    2013-01-01

    Face-to-face psychological treatments have difficulty meeting today's growing mental health needs. For the highly prevalent posttraumatic stress (PTS) conditions, accumulating evidence suggests that writing therapy may constitute an efficient treatment modality, especially when administered through the Internet. We therefore conducted a meta-analysis to investigate the efficacy of writing therapies for PTS and comorbid depressive symptoms. The literature was searched using several structured and unstructured strategies, including key word searches of the PubMed, Web of Science, PsycINFO, and PILOTS databases. Six studies met eligibility criteria and were included in the analyses. These studies included a total of 633 participants, of which 304 were assigned to writing therapy. Across 5 direct comparisons of writing therapy to waiting-list control, writing therapy resulted in significant and substantial short-term reductions in PTS and comorbid depressive symptoms. There was no difference in efficacy between writing therapy and trauma-focused cognitive behavioral therapy, but we caution that this finding was based on only 2 direct comparisons. Writing therapy is an evidence-based treatment for PTS, and constitutes a useful treatment alternative for patients who do not respond to other evidence-based treatments. Internet adaptations of writing therapy for PTS may be especially useful for reaching trauma survivors in need of evidence-based mental health care who live in remote areas or who prefer to retain their anonymity. Copyright © 2012 S. Karger AG, Basel.

  13. Post-traumatic stress in patients with injury-related chronic pain participating in a multimodal pain rehabilitation program

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    Britt-Marie Stålnacke

    2010-03-01

    Full Text Available Britt-Marie Stålnacke, Anna ÖstmanDepartment of Community Medicine and Rehabilitation, Umeå University, SwedenAim: To investigate post-traumatic stress, pain intensity, depression, and anxiety in patients with injury-related chronic pain before and after participating in multimodal pain rehabilitation.Methods: Twenty-eight patients, 21 women and seven men, who participated in the multimodal rehabilitation programs (special whiplash program for whiplash injuries within 1.5 years after the trauma or ordinary program answered a set of questionnaires to assess post-traumatic stress (Impact of Event Scale [IES], pain intensity [Visual Analogue Scale (VAS], depression, and anxiety (Hospital Anxiety and Depression Scale [HAD] before and after the programs.Results: Both pain intensity and post-traumatic stress decreased significantly after the rehabilitation programs in comparison with before (VAS: 57.8 ± 21.6 vs. 67.5 ± 21.9; P = 0.009, IES total score 21.8 ± 13.2 vs. 29.5 ± 12.9; P < 0.001. Patients younger than 40 years reported a statistically higher level of post-traumatic stress compared with patients older than 40 years both before (P = 0.037 and after rehabilitation (P = 0.023. No statistically significant differences were found on the HAD scores.Conclusion: The multimodal rehabilitation programs were effective in reducing both pain intensity and post-traumatic stress. The experience of higher levels of post-traumatic stress in younger persons has to be taken into account when managing patients with injury-related chronic pain.Keywords: post-traumatic, stress disorder, chronic pain, whiplash injuries

  14. Stress, anxiety, depression and migraine.

    Science.gov (United States)

    Wacogne, C; Lacoste, J P; Guillibert, E; Hugues, F C; Le Jeunne, C

    2003-07-01

    This study investigated the intensity of stress, anxiety and depression in a sample of 141 migraineurs compared with a control group of 109 non-migraine workers matched for age and sex. Stress was measured using the Perceived Stress Questionnaire, and anxiety and depression using the Hospital Anxiety and Depression Scale. Results indicated that stress and anxiety were higher in the migraine group than in the control group and above the clinical level. Depression scores remained low in both groups, under clinical relevance. Stress is a primordial factor in the triggering and perpetuation of migraine attacks. The high score of the items 'morning fatigue', 'intrusive thoughts about work', 'feeling under pressure', 'impatience', and 'irritability' of the stress questionnaire in the migraineurs is particularly significant in the intensive stress response. It seems necessary to manage stress to improve the daily life of migraineurs and to study the link between stress, anxiety and migraine.

  15. Maternal Posttraumatic Stress Symptoms and Infant Emotional Reactivity and Emotion Regulation

    OpenAIRE

    Enlow, Michelle Bosquet; Kitts, Robert L.; Blood, Emily; Bizarro, Andrea; Hofmeister, Michelle; Wright, Rosalind J.

    2011-01-01

    The current study examined associations between maternal posttraumatic stress disorder (PTSD) symptoms and infant emotional reactivity and emotion regulation during the first year of life in a primarily low-income, urban, ethnic/racial minority sample of 52 mother-infant dyads. Mothers completed questionnaires assessing their own trauma exposure history and current PTSD and depressive symptoms and their infants’ temperament when the infants were 6 months old. Dyads participated in the repeate...

  16. The impact of forensic investigations following assisted-suicide on post-traumatic stress disorder

    OpenAIRE

    Wagner, B.; Boucsein-Keller, Valérie; Maercker, Andreas

    2011-01-01

    In Switzerland, all deaths through assisted suicide are reported as unnatural deaths and investigated by a forensic team (police, medical examiner, and state attorney). However, there is limited knowledge concerning the impact these forensic investigations have on the development of post-traumatic stress disorder, complicated grief, or depression in those who have lost a loved one. A cross-sectional survey of 85 family members or close friends who were present at an assisted suicide was condu...

  17. Association Between Traumatic Brain Injury and Risk of Posttraumatic Stress Disorder in Active-Duty Marines

    Science.gov (United States)

    2013-01-01

    neuroscience of persistent post-concussive syndrome. J Int Neuropsychol Soc. 2008;14(1):1-22. 3. Iverson GL, Brooks BL, Lovell MR, Collins MW. No cumulative...traumatic brain injury. J Neuropsychiatry Clin Neurosci . 2011;23(1):29-39. 61. Brenner LA, Betthauser LM, Homaifar BY, et al. Posttraumatic stress...4):589-595. 67. Guskiewicz KM, Marshall SW, Bailes J, et al. Recurrent concussion and risk of depression in retired professional football players.Med

  18. Acute and post-traumatic stress disorder after spontaneous abortion.

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    Bowles, S V; James, L C; Solursh, D S; Yancey, M K; Epperly, T D; Folen, R A; Masone, M

    2000-03-15

    When a spontaneous abortion is followed by complicated bereavement, the primary care physician may not consider the diagnosis of acute stress disorder or post-traumatic stress disorder. The major difference between these two conditions is that, in acute stress disorder, symptoms such as dissociation, reliving the trauma, avoiding stimuli associated with the trauma and increased arousal are present for at least two days but not longer than four weeks. When the symptoms persist beyond four weeks, the patient may have post-traumatic stress disorder. The symptoms of distress response after spontaneous abortion include psychologic, physical, cognitive and behavioral effects; however, patients with distress response after spontaneous abortion often do not meet the criteria for acute or post-traumatic stress disorder. After spontaneous abortion, as many as 10 percent of women may have acute stress disorder and up to 1 percent may have post-traumatic stress disorder. Critical incident stress debriefing, which may be administered by trained family physicians or mental health practitioners, may help patients who are having a stress disorder after a spontaneous abortion.

  19. Children's and parents' posttraumatic stress reactions after the 2004 tsunami.

    Science.gov (United States)

    Dyb, Grete; Jensen, Tine K; Nygaard, Egil

    2011-10-01

    This study examined the association between parents' and children's posttraumatic stress reactions after the tsunami disaster in Southeast Asia in 2004. Parents of 319 Norwegian children and adolescents aged 6-18 years reported on children's exposure to the tsunami and children's immediate subjective responses. The Child Stress Disorder Checklist was used to measure children's posttraumatic stress reactions 6-8 months after the tsunami, and the Impact of Event Scale Revised measured parental PTSD. Results indicated that parents' posttraumatic stress reactions significantly predicted PTSD reactions in their children. The strongest association was found for parental intrusive reactions and hyperarousal. Highly exposed children seemed to be more vulnerable to parental distress compared to children with lower levels of exposure. The study demonstrates that parental distress can endure and worsen the impact of a disaster in children. In assessments of trauma-related consequences and in therapeutic work with children clinicians need to expand the focus to include their parents and family.

  20. The Many Presentations of Posttraumatic Stress Disorder

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    Edward J. Hickling

    2013-02-01

    Full Text Available Posttraumatic stress disorder (PTSD has been a controversial diagnosis, with concerns including the sheer number of possible minimal diagnostic combinations (1,750, increasing to >10,000 theoretical possibilities in Diagnostic and Statistical Manual of Mental Disorders (5th ed. proposals. This study examined whether the theoretical combinations postulated actually occur in a large sample of military personnel. The design of the study was a retrospective examination of PTSD checklists from 3,810 participants who, based on scores, endorsed symptoms consistent with probable PTSD. Combinations of PTSD Checklist–Civilian Version (PCL-C symptom clusters were identified using data from active-duty military personnel who completed the 2005 and the 2008 Department of Defense (DoD Health Related Behaviors Among Active Duty Military Personnel Survey. The study examined (a occurrence of combinations, (b unique minimum combinations, (c most frequent combinations, and (d replication of symptom combinations and clusters. The PCL-C scores showed 1,837 unique scoring combinations, 83.5% (1,533/1,837 of the observed unique scoring combinations occurred just once. The most frequently occurring combination (17/17 endorsed accounted for 955 participants (25.1%, the second most frequent (16/17 endorsed accounted for 75 participants (2.0%. PTSD most often presented as a unique constellation of symptom clusters, either capturing symptoms while allowing for considerable variability in its presentation, reflecting different severities of the disorder, or raising concerns about the classification itself, and any future classification that Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V might develop.

  1. One's sex, sleep, and posttraumatic stress disorder

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    Kobayashi Ihori

    2012-12-01

    Full Text Available Abstract Women are approximately twice as likely as men to develop posttraumatic stress disorder (PTSD after trauma exposure. Mechanisms underlying this difference are not well understood. Although sleep is recognized to have a critical role in PTSD and physical and psychological health more generally, research into the role of sleep in PTSD sex differences has been only recent. In this article, we review both animal and human studies relevant to sex differences in sleep and PTSD with an emphasis on the roles of sex hormones. Sleep impairment including insomnia, trauma-related nightmares, and rapid-eye-movement (REM sleep fragmentation has been observed in individuals with chronic and developing PTSD, suggesting that sleep impairment is a characteristic of PTSD and a risk factor for its development. Preliminary findings suggested sex specific patterns of sleep alterations in developing and established PTSD. Sleep maintenance impairment in the aftermath of trauma was observed in women who subsequently developed PTSD, and greater REM sleep fragmentation soon after trauma was associated with developing PTSD in both sexes. In chronic PTSD, reduced deep sleep has been found only in men, and impaired sleep initiation and maintenance with PTSD have been found in both sexes. A limited number of studies with small samples have shown that sex hormones and their fluctuations over the menstrual cycle influenced sleep as well as fear extinction, a process hypothesized to be critical to the pathogenesis of PTSD. To further elucidate the possible relationship between the sex specific patterns of PTSD-related sleep alterations and the sexually dimorphic risk for PTSD, future studies with larger samples should comprehensively examine effects of sex hormones and the menstrual cycle on sleep responses to trauma and the risk/resilience for PTSD utilizing various methodologies including fear conditioning and extinction paradigms and animal models.

  2. Recovery from depressive symptoms, state anxiety and post-traumatic stress disorder in women exposed to physical and psychological, but not to psychological intimate partner violence alone: A longitudinal study

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    Martinez Manuela

    2010-11-01

    Full Text Available Abstract Background It is well established that intimate male partner violence (IPV has a high impact on women's mental health. It is necessary to further investigate this impact longitudinally to assess the factors that contribute to its recovery or deterioration. The objective of this study was to assess the course of depressive, anxiety and post-traumatic stress disorder (PTSD symptoms and suicidal behavior over a three-year follow-up in female victims of IPV. Methods Women (n = 91 who participated in our previous cross-sectional study, and who had been either physically/psychologically (n = 33 or psychologically abused (n = 23 by their male partners, were evaluated three years later. A nonabused control group of women (n = 35 was included for comparison. Information about mental health status and lifestyle variables was obtained through face-to-face structured interviews. Results Results of the follow-up study indicated that while women exposed to physical/psychological IPV recovered their mental health status with a significant decrease in depressive, anxiety and PTSD symptoms, no recovery occurred in women exposed to psychological IPV alone. The evolution of IPV was also different: while it continued across both time points in 65.21% of psychologically abused women, it continued in only 12.12% of physically/psychologically abused women while it was reduced to psychological IPV in 51.5%. Hierarchical multiple regression analyses indicated that cessation of physical IPV and perceived social support contributed to mental health recovery, while a high perception of lifetime events predicted the continuation of PTSD symptoms. Conclusion This study shows that the pattern of mental health recovery depends on the type of IPV that the women had been exposed to. While those experiencing physical/psychological IPV have a higher likelihood of undergoing a cessation or reduction of IPV over time and, therefore, could recover, women exposed to

  3. Post-traumatic stress disorder and cardiovascular disease.

    Science.gov (United States)

    Edmondson, Donald; von Känel, Roland

    2017-04-01

    In this paper, a first in a Series of two, we look at the evidence for an association of post-traumatic stress disorder with incident cardiovascular disease risk and the mechanisms that might cause this association, as well as the prevalence of post-traumatic stress disorder due to cardiovascular disease events and its associated prognostic risk. We discuss research done after the publication of previous relevant systematic reviews, and survey currently funded research from the two most active funders in the field: the National Institutes of Health and the US Veterans Administration. We conclude that post-traumatic stress disorder is a risk factor for incident cardiovascular disease, and a common psychiatric consequence of cardiovascular disease events that might worsen the prognosis of the cardiovascular disease. There are many candidate mechanisms for the link between post-traumatic stress disorder and cardiovascular disease, and several ongoing studies could soon point to the most important behavioural and physiological mechanisms to target in early phase intervention development. Similarly, targets are emerging for individual and environmental interventions that might offset the risk of post-traumatic stress disorder after cardiovascular disease events.

  4. The war within : Neurobiological alterations in posttraumatic stress disorder

    NARCIS (Netherlands)

    Geuze, E.

    2006-01-01

    For a large number of veterans, war does not end after they are removed from a combat zone. Traumatic stress affects nearly all veterans, but while the majority of veterans learn to live with their experiences, for some veterans traumatic stress seethes inside. In this dissertation posttraumatic str

  5. [Clinical approach to post-traumatic stress disorders].

    Science.gov (United States)

    Boussaud, Marie

    2015-01-01

    A confrontation with death can lead to acute reactions of stress, followed possibly, after a phase of latency, by post-traumatic stress disorder (PTSD). PTSD is characterised by the appearance of a repetition syndrome combining reliving, hypervigilance and avoidance; comorbidities frequently arise, increasingthe risk of suicide. Caregivers have an important role to play in identifying them.

  6. The war within : Neurobiological alterations in posttraumatic stress disorder

    NARCIS (Netherlands)

    Geuze, E.

    2006-01-01

    For a large number of veterans, war does not end after they are removed from a combat zone. Traumatic stress affects nearly all veterans, but while the majority of veterans learn to live with their experiences, for some veterans traumatic stress seethes inside. In this dissertation posttraumatic

  7. Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples

    Directory of Open Access Journals (Sweden)

    Ask Elklit

    2014-05-01

    Full Text Available Background: The International Classification of Diseases, 11th version (ICD-11, proposes two related stress and trauma-related disorders, posttraumatic stress disorder (PTSD and complex PTSD (CPTSD. A diagnosis of CPTSD requires that in addition to the PTSD symptoms, an individual must also endorse symptoms in three major domains: (1 affective dysregulation, (2 negative self-concepts, and (3 interpersonal problems. This study aimed to determine if the naturally occurring distribution of symptoms in three groups of traumatised individuals (bereavement, sexual victimisation, and physical assault were consistent with the ICD-11, PTSD, and CPTSD specification. The study also investigated whether these groups differed on a range of other psychological problems. Methods and Results: Participants completed self-report measures of each symptom group and latent class analyses consistently found that a three class solution was best. The classes were “PTSD only,” “CPTSD,” and “low PTSD/CPTSD.” These classes differed significantly on measures of depression, anxiety, dissociation, sleep disturbances, somatisation, interpersonal sensitivity, and aggression. The “CPTSD” class in the three samples scored highest on all the variables, with the “PTSD only” class scoring lower and the “low PTSD/CPTSD” class the lowest. Conclusion: This study provides evidence to support the diagnostic structure of CPTSD and indicted that CPTSD is associated with a broad range of other psychological problems.

  8. Course and predictors of posttraumatic stress among male train drivers after the experience of 'person under the train' incidents.

    Science.gov (United States)

    Mehnert, Anja; Nanninga, Imke; Fauth, Mathias; Schäfer, Ingo

    2012-09-01

    The present prospective study aimed to identify the frequency and course of posttraumatic stress symptoms, anxiety, depression, and quality of life in train drivers after the experience of 'person under the train' incidents. Furthermore, associations between predictors of posttraumatic stress stratified by pre-, peri- and posttraumatic factors, psychological distress, quality of life (QoL), sense of coherence, lack of meaning in life, and post-trauma thoughts are analyzed. Patients (100% male, mean age 48 years) were assessed at the beginning (n=73), at the end (n=71) and six months (n=49) after a four-week rehabilitation program and completed validated self-report questionnaires (e.g. Posttraumatic Diagnostic Scale, Hospital Anxiety and Depression Scale, Short-Form Health Survey). Train drivers experienced averagely 1.8 'person under the train' incidents (range 1-8); the majority (81%) was involved in a railway suicide. At the beginning of the rehabilitation, 44% of the patients were classified as having moderate to severe PTSD, and 14% as having severe PTSD. Posttraumatic stress decreased significantly over time (p=.003, η²=.17). We found no significant differences in the course of posttraumatic stress, anxiety, depression, distress and QoL between patients who experienced one or more than one railway related accident or suicide. Anxiety, sense of guilt and sense of alienation emerged as the most important factors in predicting posttraumatic stress six months after rehabilitation (R²=0.55). Findings emphasize the importance of rehabilitation programs for train drivers after railway-related incidents. However, research is needed to develop effective rehabilitation interventions particularly tailored to this patient group. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Work stress and posttraumatic stress disorder in ED nurses/personnel.

    Science.gov (United States)

    Laposa, Judith M; Alden, Lynn E; Fullerton, Louise M

    2003-02-01

    Work-related stress in the emergency department previously has been linked to depression and burnout; however, these findings have not been extended to the development of anxiety disorders, such as posttraumatic stress disorder (PTSD). Three sets of factors have been shown to contribute to stress in ED personnel: organizational characteristics, patient care, and the interpersonal environment. The current study addressed whether an association exists between sources of workplace stress and PTSD symptoms. Respondents were 51 ED personnel from a hospital in a large Canadian urban center. The majority of respondents were emergency nurses. Respondents completed questionnaires measuring PTSD and sources of work stress and answered a series of questions regarding work-related responses to stress or trauma. Interpersonal conflict was significantly associated with PTSD symptoms. The majority of respondents (67%) believed they had received inadequate support from hospital administrators following the traumatic incident and 20% considered changing jobs as a result of the trauma. Only 18% attended critical incident stress debriefing and none sought outside help for their distress. These findings underscore the need for hospital administrations to be aware of the extent of workplace stress and PTSD symptoms in their employees. Improving the interpersonal climate in the workplace may be useful in ameliorating PTSD symptoms.

  10. Experiential Acceptance and Trait-Mindfulness as Predictors of Analogue Posttraumatic Stress

    NARCIS (Netherlands)

    Boelen, Paul A.; Lenferink, Lonneke

    2017-01-01

    Objectives. Experiential acceptance and trait-mindfulness are associated with posttraumatic stress disorder (PTSD) after traumatic events. The current study was a preliminary attempt to examine (i) associations of experiential acceptance and traitmindfulness with posttraumatic stress (PTS) associate

  11. Anticonvulsants to treat post-traumatic stress disorder.

    Science.gov (United States)

    Wang, Hee Ryung; Woo, Young Sup; Bahk, Won-Myong

    2014-09-01

    We reviewed the existing literature on the efficacy of anticonvulsants in treating post-traumatic stress disorder. We performed a literature search using PubMed, EMBASE and the Cochrane database on 30 September 2013. Randomized,controlled studies that investigated the efficacy of anticonvulsants for post-traumatic stress disorder were included in this review. Studies with retrospective designs, case reports and case series were excluded. A total of seven studies met the inclusion criteria for this review. Three studies used topiramate with negative findings regarding its efficacy. Two studies used divalproex, both of which failed to show superiority over placebo. One study used lamotrigine, with favourable results, and one study used tiagabine, with negative results. Future long-term studies with larger sample sizes are needed to investigate the clinical utility of anticonvulsants for posttraumatic stress disorder treatment.

  12. Posttraumatic stress disorder in the wake of heart disease

    DEFF Research Database (Denmark)

    Spindler, Helle; Pedersen, Susanne S.

    2014-01-01

    There is increasing recognition that patients after a cardiac event may be at risk of posttraumatic stress disorder (PTSD). The present article reviews studies looking at PTSD as a sequel of heart disease with a focus on prevalence, risk factors, and future research directions.......There is increasing recognition that patients after a cardiac event may be at risk of posttraumatic stress disorder (PTSD). The present article reviews studies looking at PTSD as a sequel of heart disease with a focus on prevalence, risk factors, and future research directions....

  13. Alexithymia and posttraumatic stress disorder following asthma attack.

    Science.gov (United States)

    Chung, Man Cheung; Wall, Natalie

    2013-09-01

    This study examined the levels of posttraumatic stress disorder (PTSD) following asthma attack (post-asthma attack PTSD) and psychiatric co-morbidity among college students. It also investigated the association between these variables and alexithymia. One hundred and six college students participated in the study and completed an on-line survey comprising the Asthma Symptom Checklist, PTSD Checklist, General Health Questionnaire-28 and Toronto Alexithymia Scale. Ninety-one students without asthma and major illness formed the control group. 2 % met the diagnostic criteria for full-PTSD, while 42 and 56 % met the partial and no-PTSD criteria respectively. Compared with the control, the asthma group reported significantly more somatic problems, social dysfunction and depression and was five times more likely to have an elevated risk of developing a general psychiatric disorder. After adjusting age, marital status, asthma experience and symptoms, alexithymia did not predict PTSD, while difficulty identifying feelings predicted psychiatric co-morbidity. Mediational analyses showed that asthma symptoms partially mediated the link between difficulty identifying feelings and psychiatric co-morbidity. People can develop PTSD symptoms and other psychological difficulties following asthma attack. Alexithymia influenced general psychological difficulties independently of PTSD symptoms.

  14. Sudden gains in two psychotherapies for posttraumatic stress disorder.

    Science.gov (United States)

    König, Julia; Karl, Regina; Rosner, Rita; Butollo, Willi

    2014-09-01

    We examined sudden, large, and stable shifts in symptoms from one therapy session to the next in two treatments for posttraumatic stress disorder (PTSD). Shifts in a positive direction (sudden gains) have so far been more frequently analyzed than those in a negative direction (sudden losses). We analyzed data from 102 outpatients suffering from PTSD who received either a cognitive-behavioral or a Gestalt-based intervention. Sudden gains, at 22.5%, were more frequent than sudden losses (3.9% of patients). Participants who had experienced sudden gains had lower PTSD scores at posttreatment, but not at the 6-month follow-up. As sudden losses were so rare, they were not analyzed statistically. Sudden gains accounted for 52% of overall treatment gains or 26% of overall change in a positive direction. Among very successful patients, those with sudden gains were overrepresented, but in absolute terms, there were as many patients without sudden gains in this group. There was no connection between sudden gains and type of intervention or depressive symptoms. Sudden gains and sudden losses occurred in our sample of PTSD patients, but in the light of current results, their clinical importance seems to be limited.

  15. Cognitive processes in post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Gamze Yıldırımlı

    2012-11-01

    Full Text Available Post-Traumatic Stress Disorder (PTSD consists of a pattern of symptoms that include cognitive, affective, sensory and behavioral systems. In PTSD, the individual experiences disturbing emotions and sensations such as anxiety, panic, depression, anger, tension, high startle response and hyper-vigilance as a result of re-experiencing traumatic memories, flashbacks, attention difficulties, memory loss, nightmares and intrusive thoughts. To get rid of these emotions, he avoids all stimuli that remind the traumatic event. The cognitive approach asserts that cognitions play a triggering and maintaining role for these symptoms and tries to explain them with the information processing framework. According to this approach, the traumatic event that is experienced is processed differently from daily, ordinary events. This different information processing strategy stands out in attention, memory, dissociation, cognitive beliefs, cognition-affect processes and coping strategies. In the present paper, research on how these constructs that are parts of the information processing in cognitive systems function in PTSD will be reviewed.

  16. Neural mechanisms of impaired fear inhibition in posttraumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Tanja eJovanovic

    2011-07-01

    Full Text Available Posttraumatic stress disorder (PTSD can develop in some individuals who are exposed to an event that causes extreme fear, horror, or helplessness (APA, 1994. PTSD is a complex and heterogeneous disorder, which is often co-morbid with depression, substance abuse, and anxiety disorders such as panic or social phobia. Given this complexity, progress in the field can be greatly enhanced by focusing on phenotypes that are more proximal to the neurobiology of the disorder. Such neurobiological intermediate phenotypes can provide investigative tools to increase our understanding of the roots of the disorder and develop better prevention or intervention programs. In the present paper, we argue that the inhibition of fear responses is an intermediate phenotype that is related to both the neurocircuitry associated with the disorder, and is linked to its clinical symptoms. An advantage of focusing on fear inhibition is that the neurobiology of fear has been well investigated in animal models providing the necessary groundwork in understanding alterations. Furthermore, because many paradigms can be tested across species, fear inhibition is an ideal translational tool. Here we review both the behavioral tests and measures of fear inhibition and the related neurocircuitry in neuroimaging studies with both healthy and clinical samples.

  17. The treatment of posttraumatic stress disorder and related psychosocial consequences of burn injury: a pilot study.

    Science.gov (United States)

    Cukor, Judith; Wyka, Katarzyna; Leahy, Nicole; Yurt, Roger; Difede, JoAnn

    2015-01-01

    Burn injuries are unique in their medical and psychological impact, yet there has been little exploration of psychiatric treatment for this population. This uncontrolled pilot study assessed feasibility, acceptability, and preliminary efficacy of a treatment protocol designed to address posttraumatic stress disorder, depression, coping with scarring, and community integration among adult burn survivors. A 14-session, manualized treatment protocol was created using cognitive-behavioral interventions including imaginal exposure, behavioral activation, cognitive restructuring, modeling, and in vivo exposure. Responses were measured using the Clinician Administered PTSD Scale, Beck Depression Index, Community Integration Questionnaire, Oswestry Disability Questionnaire, and Burn Specific Health Scale. Nine of 10 enrolled patients (60% women; mean = 42 years old) completed treatment. Burn size was 0.5% to 65%; mechanism of injury included flame (4), scald (5), and contact (1) burns. Mean acute hospitalization was 30.1 days (range = 13-87); mean time from injury to treatment was 3.2 months (range = 1-7). Baseline mean posttraumatic stress score was 68 on the Clinician Administered PTSD Scale (severe); scores decreased by 36% to a mean of 45.3 at posttreatment, with a large effect size. Baseline self-reported depression was 21 (moderate) on the Beck Depression Index, decreasing by 47% to a mean of 12 posttreatment (nonclinical). Change in community reintegration score was significant and large, and body image showed significant improvement. The protocol showed promise in the treatment of posttraumatic stress disorder, depression, self-image, and community reintegration following burn injury. These findings suggest that coping may improve with treatment and symptoms should not be dismissed as unavoidable consequences of burn injury.

  18. Predicting post-traumatic stress disorder treatment response in refugees: Multilevel analysis.

    Science.gov (United States)

    Haagen, Joris F G; Ter Heide, F Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J

    2017-03-01

    Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. The presence (B = 6.5, p = .03) and severity (B = 6.3, p Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. There are differences in post-traumatic stress disorder (PTSD) treatment response between traumatized refugees. Comorbid depressive disorder and depression severity predict poor PTSD response. Refugees with PTSD and severe depression may not benefit from PTSD treatment. Targeting comorbid severe depression before PTSD treatment is warranted. This study did not correct for multiple hypothesis testing. Comorbid depression may differentially impact alternative PTSD treatments. © 2016 The British Psychological Society.

  19. Post-Traumatic Stress Disorder in Kosovo Veterans

    Directory of Open Access Journals (Sweden)

    Mimoza Shahini

    2016-03-01

    Full Text Available Objective: The objective of this study was to explore the prevalence of post-traumatic stress disorder (PTSD at veterans 8 years after war, to find out relation of PTSD with other demographic and health related variables and discover the impact of depression and trauma on PTSD on 687 veterans from six municipalities in Kosovo. Method: Participants were 687 war veterans selected from six regions of Kosovo during 2008. The Harvard Trauma Questionnaire (HTQ-40, was administered to measure PTSD and Hopkins Symptom Checklist (HSCL-25 for depression and anxiety. Pearson chi-square, analysis of variance (ANOVA, and multiple regressions were used to analyze the data. Results: Results indicated that 11.2 % of veterans even 8 years after the war ended were suffering from PTSD. Six percent of veterans with PTSD did not seek medical help. They reported to have had emotional problems and physical problems, but they did not seek medical help. The findings suggest that self-medication may be one way of veterans dealing with PTSD symptoms. Veterans with PTSD symptoms were more concerned with “family issues” than those without PTSD symptoms. Conclusions: The study found that 8 years after the war the veterans of the war in Kosovo suffer PTSD symptoms and that a good number of them do not seek help for this problem. The establishment of adequate services by the state would transform these veterans’ dealing with PTSD not into a moral challenge but into a fundamental right to equal and high-quality services.

  20. Chronic obstructive lung disease and posttraumatic stress disorder: current perspectives

    Directory of Open Access Journals (Sweden)

    Abrams TE

    2015-10-01

    Full Text Available Thad E Abrams,1,2 Amy Blevins,1,3 Mark W Vander Weg1,2,4 1Department of Internal Medicine, University of Iowa, 2Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City VA Health Care System, 3Hardin Health Sciences Library, 4Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA Background: Several studies have reported on the co-occurrence of chronic obstructive pulmonary disease (COPD and psychiatric conditions, with the most robust evidence base demonstrating an impact of comorbid anxiety and depression on COPD-related outcomes. In recent years, research has sought to determine if there is a co-occurrence between COPD and posttraumatic stress disorder (PTSD as well as for associations between PTSD and COPD-related outcomes. To date, there have been no published reviews summarizing this emerging literature.Objectives: The primary objective of this review was to determine if there is adequate evidence to support a co-occurrence between PTSD and COPD. Secondary objectives were to: 1 determine if there are important clinical considerations regarding the impact of PTSD on COPD management, and 2 identify targeted areas for further research.Methods: A structured review was performed using a systematic search strategy limited to studies in English, addressing adults, and to articles that examined: 1 the co-occurrence of COPD and PTSD and 2 the impact of PTSD on COPD-related outcomes. To be included, articles must have addressed some type of nonreversible obstructive lung pathology.Results: A total of 598 articles were identified for initial review. Upon applying the inclusion and exclusion criteria, n=19 articles or abstracts addressed our stated objectives. Overall, there is inconclusive evidence to support the co-occurrence between PTSD and COPD. Studies finding a significant co-occurrence generally had inferior methods of identifying COPD; in contrast, studies that utilized more robust COPD

  1. Posttraumatic stress and anxiety in patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Habibović, Mirela; Denollet, J; Pedersen, S S

    2017-01-01

    the trajectories of symptoms of posttraumatic stress disorder (PTSD) and anxiety in patients with an ICD and the vulnerability factors associated with an increased risk of symptoms of PTSD and anxiety. METHODS: A total of 249 patients were included as part of the WEB-based distress program for implantable...... CARdioverter dEfibrillator patients (WEBCARE) study. Data were analyzed using Latent class analyses, with trajectories of PTSD symptomatology and anxiety examined between baseline and 12 months follow-up. RESULTS: The mean age of the sample was 58.9±9.8, with the majority being male (82%). Latent Class...... analyses (LatentGOLD) revealed four classes with respect to PTSD symptomatology, and three classes of patients with respect to anxiety. Younger age, increased depression score at baseline, and Type D personality were all associated with increased vulnerability for posttraumatic stress and anxiety symptoms...

  2. Pharmacotherapy as prophylactic treatment of post-traumatic stress disorder: a review of the literature.

    Science.gov (United States)

    Roque, Autumn Pearl

    2015-01-01

    Post-traumatic stress disorder has a lifetime prevalence of almost 9% in the United States. The diagnosis is associated with increased rates of comorbid substance abuse and increased rates of depression. Providers are taught how to diagnose and treat PTSD, but little discussion is devoted to how to prevent the disorder. Behavioral research in animal studies has provided some evidence for the use of medications in decreasing the fear response and the reconsolidation of memories. A heightened fear response and the re-experience of traumatic memory are key components for diagnosis. The purpose of this literature review is to examine the evidence for pharmacotherapy as prophylactic treatment in acute stress/trauma in order to prevent the development of post-traumatic stress disorder. The body of the review includes discussions on medications, medications as adjunct to script-driven imagery, and special considerations for military, first responders, and women. This article concludes with implications for practice and recommendations for future research. The key words used for the literature search were "prophylactic treatment of PTSD," "pharmacotherapy and trauma," "pharmacological prevention of PTSD," "beta blockers and the prevention of PTSD," "acute stress and prevention of PTSD," "propranolol and PTSD," "secondary prevention of PTSD," and "medications used to prevent PTSD." Findings were categorized by medications and medications as adjunct to script-driven imagery. The literature suggests that hydrocortisone, propranolol, and morphine may decrease symptoms and diagnosis of post-traumatic stress disorder.

  3. Predicting Posttraumatic Stress Symptoms in Children after Road Traffic Accidents

    Science.gov (United States)

    Landolt, Markus A.; Vollrath, Margarete; Timm, Karin; Gnehm, Hanspeter E.; Sennhauser, Felix H.

    2005-01-01

    Objective: To prospectively assess the prevalence, course, and predictors of posttraumatic stress symptoms (PTSSs) in children after road traffic accidents (RTAs). Method: Sixty-eight children (6.5-14.5 years old) were interviewed 4-6 weeks and 12 months after an RTA with the Child PTSD Reaction Index (response rate 58.6%). Their mothers (n = 60)…

  4. Posttraumatic stress disorder following preeclampsia and HELLP syndrome

    NARCIS (Netherlands)

    van Pampus, MG; Wolf, H; Schultz, WCMW; Neeleman, J; Aarnoudse, JG

    2004-01-01

    Posttraumatic stress disorder (PTSD) in connection with pregnancy was first described in the 1990s-initially in relation to childbirth but later more specifically to the mode of delivery. Instrumental vaginal delivery carries the highest risk of PTSD followed by emergency caesarean section and norma

  5. Posttraumatic Stress in Adolescents with Asthma and Their Parents

    Science.gov (United States)

    Kean, Emily Millikan; Kelsay, Kimberly; Wamboldt, Frederick; Wamboldt, Marianne Z.

    2006-01-01

    Objective: To assess posttraumatic stress (PTS) symptoms in adolescents with and without asthma and their parents and the relationship between PTS symptoms and asthma morbidity. Method: Three groups of adolescents (12-18 years) participated: adolescents who had experienced a life-threatening asthma episode (n = 49), asthma controls (n = 71), and…

  6. Harm expectancy violation during exposure therapy for posttraumatic stress disorder

    NARCIS (Netherlands)

    Kleine, R.A. de; Hendriks, L.; Becker, E.S.; Broekman, T.G.; Minnen, A. van

    2017-01-01

    Exposure therapy has proven efficacy in the treatment of posttraumatic stress disorder (PTSD). Emotional processing theory proposes that fear habituation is a central mechanism in symptom reduction, but the empirical evidence supporting this is mixed. Recently it has been proposed that violation of

  7. Disaster-related posttraumatic stress disorder and physical health

    NARCIS (Netherlands)

    Dirkzwager, J.E.; van der Velden, P.G.; Grievink, Linda; Yzermans, C.J.

    2007-01-01

    Objective: To examine the relationship between posttraumatic stress disorder (PTSD) and self-reported as well as physicianrecorded physical health in a sample of survivors (n 896) of a man-made disaster, using a longitudinal design that included predisaster health data. Most studies on the relations

  8. Early identification of posttraumatic stress following military deployment

    DEFF Research Database (Denmark)

    Karstoft, Karen-Inge; Statnikov, Alexander; Andersen, Søren B

    2015-01-01

    BACKGROUND: Pre-deployment identification of soldiers at risk for long-term posttraumatic stress psychopathology after home coming is important to guide decisions about deployment. Early post-deployment identification can direct early interventions to those in need and thereby prevents the develo...

  9. Identification of Characteristics and Causes of Childhood Posttraumatic Stress Disorder.

    Science.gov (United States)

    Motta, Robert W.

    1994-01-01

    Notes growing interest in children with Posttraumatic Stress Disorder (PTSD) and suspicion that rise in family violence, violence in schools, and other stressors may lead to characteristic PTSD symptoms of reexperiencing trauma, psychological numbing, and increased states of arousal. Examines characteristics of childhood PTSD and its causes.…

  10. Neuropsychological Effects of Posttraumatic Stress Disorder in Children and Adolescents

    Science.gov (United States)

    Turley, Matthew R.; Obrzut, John E.

    2012-01-01

    Posttraumatic Stress Disorder (PTSD) can affect people of all ages but the literature is lacking on children and adolescents who experience PTSD. The consequences of this disorder extend beyond the basic symptoms by which it is defined. Neuroanatomically, the brains of children with PTSD have been found to be abnormally symmetrical in several…

  11. The auditory startle response in post-traumatic stress disorder

    NARCIS (Netherlands)

    Siegelaar, S. E.; Olff, M.; Bour, L. J.; Veelo, D.; Zwinderman, A. H.; van Bruggen, G.; de Vries, G. J.; Raabe, S.; Cupido, C.; Koelman, J. H. T. M.; Tijssen, M. A. J.

    2006-01-01

    Post-traumatic stress disorder (PTSD) patients are considered to have excessive EMG responses in the orbicularis oculi (OO) muscle and excessive autonomic responses to startling stimuli. The aim of the present study was to gain more insight into the pattern of the generalized auditory startle reflex

  12. Posttraumatic Stress in Women with Breast Cancer and Their Daughters.

    Science.gov (United States)

    Boyer, Bret A.; Bubel, Denise; Jacobs, Sheri R.; Knolls, Michelle L.; Harwell, Valerie D.; Goscicka, Magdalena; Keegan, Anne

    2002-01-01

    Twenty-one percent of the surveyed women (N=133) with cancer and 13% of their daughters (N=64) reported symptoms of posttraumatic stress disorder (PTSD). Prevalence of PTSD symptoms in daughters appears comparable to women with breast cancer. Discusses intergenerational patterns in reaction to breast cancer. (JDM)

  13. Predicting Posttraumatic Stress Symptoms in Children after Road Traffic Accidents

    Science.gov (United States)

    Landolt, Markus A.; Vollrath, Margarete; Timm, Karin; Gnehm, Hanspeter E.; Sennhauser, Felix H.

    2005-01-01

    Objective: To prospectively assess the prevalence, course, and predictors of posttraumatic stress symptoms (PTSSs) in children after road traffic accidents (RTAs). Method: Sixty-eight children (6.5-14.5 years old) were interviewed 4-6 weeks and 12 months after an RTA with the Child PTSD Reaction Index (response rate 58.6%). Their mothers (n = 60)…

  14. Borderline Personality Disorder and Posttraumatic Stress Disorder: Time for Integration?

    Science.gov (United States)

    Hodges, Shannon

    2003-01-01

    An increasing prevalence of borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) diagnoses among women illustrates problems and limitations of the medical model system. Article explores overlapping relationship between BPD and PTSD and critiques how both are viewed within the mental health community. Previous research is…

  15. Trauma Exposure and Posttraumatic Stress Disorder in Delinquent Female Adolescents

    Science.gov (United States)

    Ariga, Michio; Uehara, Toru; Takeuchi, Kazuo; Ishige, Yoko; Nakano, Reiko; Mikuni, Masahiko

    2008-01-01

    Background: Although juveniles within the justice system have high psychiatric morbidity, few comprehensive investigations have shown posttraumatic stress disorder (PTSD) in female delinquents. Here, we aim to describe the nature and extent of PTSD and trauma exposure and to clarify the relationships among comorbidity and psychosocial factors in…

  16. Identification of Risk Factors for Chronic Posttraumatic Stress Disorder (PTSD)

    Science.gov (United States)

    2009-06-01

    Miller, Wolf, Martin , Kaloupek, & Keane, 2008). Furthermore, PTSD hyperarousal symptoms have been linked to greater aggressive tendencies among male...dimensional conceptualization of posttraumatic stress reactions on the basis of taxometric procedures (e.g. Forbes, Haslam, Williams, & Creamer , 2005) and...New York State Psychiatric Institute, Biometrics Research. Forbes, D., Haslam, N., Williams, B. J., & Creamer , M. (2005). Testing the latent

  17. Connection and Recovery: Posttraumatic Stress Disorder and School Reintegration.

    Science.gov (United States)

    Cook-Cottone, Catherine

    This paper provides an introduction to Posttraumatic Stress Disorder (PTSD) in a manner that facilitates the interested learner's further exploration. It presents theoretical references and reviews the social factors and epidemiology of PTSD in children and adolescents. The psychobiology of PTSD is described in relation to the types of memory it…

  18. The use of clonidine in post-traumatic stress disorder.

    Science.gov (United States)

    Porter, D M; Bell, C C

    1999-08-01

    This case report examines the use of clonidine to successfully treat a child suffering from post-traumatic stress disorder (PTSD). This case shows an unintentional washout period that exemplifies a cause-effect relationship between clonidine and the inhibition of reenactment symptoms of PTSD.

  19. The Psychophysiology of Posttraumatic Stress Disorder: A Meta-Analysis

    Science.gov (United States)

    Pole, Nnamdi

    2007-01-01

    This meta-analysis of 58 resting baseline studies, 25 startle studies, 17 standardized trauma cue studies, and 22 idiographic trauma cue studies compared adults with and without posttraumatic stress disorder (PTSD) on psychophysiological variables: facial electromyography (EMG), heart rate (HR), skin conductance (SC), and blood pressure.…

  20. Children and adolescents treated for post-traumatic stress disorder ...

    African Journals Online (AJOL)

    Children and adolescents can develop post-traumatic stress disorder (PTSD) after ... political or community violence, violent crime, physical and sexual abuse, ... the Free State Psychiatric Complex (FSPC) were screened for the diagnosis of ... isolation (39%), fear or anxiety (37%), problematic family relationships (29%), ...

  1. Correlation between Kind of Delivery and Posttraumatic Stress ...

    African Journals Online (AJOL)

    disasters, problems, and domestic violence. ... 1Social Determinant of Health Research Center, Alborz University of Medical Sciences, 2Faculty of Nursing and Midwifery, ... Background: Posttraumatic stress disorder (PTSD) is a very common mental condition and ... at the initial stage of the study, who were then followed up.

  2. Occurrence of delayed-onset post-traumatic stress disorder

    DEFF Research Database (Denmark)

    Utzon-Frank, Nicolai; Breinegaard, Nina; Bertelsen, Mette

    2014-01-01

    Post-traumatic stress disorder (PTSD) develops according to consensus criteria within the first 1-6 months after a horrifying traumatic event, but it is alleged that PTSD may develop later. The objective was to review the evidence addressing occurrence of PTSD with onset >6 months after a traumatic...

  3. Posttraumatic stress disorder among bereaved relatives of cancer patients

    DEFF Research Database (Denmark)

    Elklit, A.; Reinholt, Nina; Nielsen, Louise Hjort

    2010-01-01

    The aim of this study was to assess post-traumatic stress disorder (PTSD) and predictors of PTSD in individuals who experienced the loss of a close relative to cancer. A total of 251 bereaved relatives ages 14 to 76 (M = 41.3, SD = 16.8) were recruited at a counseling service for cancer patients...

  4. Cerebral basis of posttraumatic stress disorder following the Chernobyl disaster.

    Science.gov (United States)

    Loganovsky, Konstantin N; Zdanevich, Nataliya A

    2013-04-01

    Whether posttraumatic stress disorder (PTSD) following radiation emergency has psychopathological, neurocognitive, and neurophysiological peculiarities is at issue. The goal was to explore the features and cerebral basis of "radiation" PTSD in the survivors of the Chernobyl accident. Subjects and Methods The cross-sectional study included 241 people, 219 of whom have been diagnosed with PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria, among them 115 clean-up workers of the Chernobyl accident (34 with acute radiation sickness), 76 evacuees from the Chernobyl exclusion zone, 28 veterans of the war in Afghanistan, and 22 healthy unexposed individuals. Psychometric examinations, neurocognitive assessments, computerized electroencephalography, and cerebral vascular Doppler were used. "Radiation" PTSD includes "flashforward" phenomena and anticipating stress (projection of fear and danger to the future); somatoform disorders (depression, trait and state anxiety); and neurocognitive deficit (impaired memory and attention, auditory-verbal memory and learning, proactive and retroactive interference, cerebellar and stem symptoms, intellectual changes). The intima-media component, thickness of common carotid arteries, and common and left internal carotid arteries stenosis rates are increased in the liquidators. Changes of bioelectrical brain activity as a decrease of beta- and theta-power, together with an increase of alpha-power, were found in the Chernobyl accident survivors with PTSD. PTSD following radiation emergency is characterized by comorbidity of psychopathology, neurocognitive deficit, and cerebrovascular pathology with increased risk of cerebral atherosclerosis and stroke. The cerebral basis of this PTSD is proposed to be an abnormal communication between the pyramidal cells of the neocortex and the hippocampus, and deep brain structures. It is recommended that a system of emergency and long-term psychological

  5. Stress and Depression in Children

    Directory of Open Access Journals (Sweden)

    Kourmousi N.

    2015-10-01

    Full Text Available Childhood depression is a matter of major concern because of its growing prevalence, the fact that it is not a transitional situation that most children seem to outgrow, and also because of the impairment of functioning that it causes. There have been many epidemiological and clinical investigations that have identified the children who are at risk of developing depression. Stress in particular, seems to be the dominant risk factor, so models of stress and developmental psychopathology response have begun to possess a significant position in the literature of childhood depression. Some researchers have accepted the mere accumulation of risk factors as a cause leading to depression, while others have proposed integrated multilevel models, which argue that children with a predisposition are at increased risk for depression when facing stressful life events. Additionally, this vulnerability increases their chances to encounter stress, while reducing their abilities to cope with it when it occurs. The purpose of this review is to study the way stress correlates to childhood depression in the existing literature, in order to highlight the help that can be provided by preventive mental health intervention programs which include ways of developing and strengthening protective factors and ways of coping with stress.

  6. Somatic reenactment in the treatment of posttraumatic stress disorder.

    Science.gov (United States)

    Lindy, J D; Green, B L; Grace, M

    1992-01-01

    Somatic reenactments, like other intrusive symptoms in post-traumatic stress disorder, such as flashbacks and nightmares, reproduce the mental content of traumatic events. Four cases are presented from survivors of military trauma and civilian catastrophes. The patients were part of larger research projects carried out by the University of Cincinnati Traumatic Stress Study Center. Understanding such symptoms as repetitions of the trauma itself proved useful therapeutically, especially in consolidating the working alliance.

  7. Posttraumatic Stress Symptoms and Nonmedical Prescription Drug Use Among College Students With Trauma Exposure.

    Science.gov (United States)

    Ham, Lindsay S; Wiersma-Mosley, Jacquelyn D; Feldner, Matthew T; Melkonian, Alexander J; Milner, Lauren A; Lewis, Sarah F

    2016-01-01

    Nonmedical prescription drug use, defined as using the drug without a prescription or in ways for which it is not prescribed, and traumatic event exposure are highly prevalent among college students. Despite evidence that posttraumatic stress symptoms could place college students at risk for nonmedical prescription drug problems, no studies have examined this relationship. This study was a preliminary examination of posttraumatic stress symptoms, lifetime nonmedical prescription drug use, hazardous use, and dependence symptoms among college students with trauma exposure. Participants were students attending a rural college in Virginia, recruited through psychology classes, flyers, LISTSERVs, and announcements at student events. All students who reported experiencing at least one traumatic event were included (N = 119); participants' mean age was 19.7 years (SD = 1.90), about half were women (n = 63, 53%), and most were Caucasian (n = 103, 87%). Nearly 60% of participants (n = 71) reported using nonmedical prescription drugs at least once during their lifetime and were more likely than those with no use to report hazardous alcohol use (p stress symptom frequency was positively associated with hazardous nonmedical prescription drug use, after controlling for gender, depressive symptoms, and hazardous alcohol use (p stress symptom frequency was higher for those with any nonmedical prescription drug dependence symptoms (p student had ever engaged in nonmedical prescription drug use. Findings suggest that consideration of the types of behaviors and problems a college student is experiencing related to nonmedical prescription drug use may be more relevant to posttraumatic stress symptom frequency than dichotomous measures of nonmedical prescription drug use alone. Further, the association between the frequency of posttraumatic stress symptoms and both hazardous nonmedical prescription drug use and dependence symptoms among college students with a trauma history deserves

  8. Differences in posttraumatic stress reactions between witnesses and direct victims of motor vehicle accidents.

    Science.gov (United States)

    Tierens, Marlies; Bal, Sarah; Crombez, Geert; Loeys, Tom; Antrop, Inge; Deboutte, Dirk

    2012-06-01

    The present study describes posttraumatic stress reactions in young witnesses of motor vehicle accidents (MVAs). This study investigated (a) whether witnesses of MVAs report fewer trauma symptoms than direct victims, but more than adolescents who were never exposed to an MVA; and (b) whether individual differences in sex, negative appraisal, avoidant coping, and social support account for variability in trauma symptoms beyond status as a witness as compared to a victim. Self-report data came from a community-based sample of 3,007 adolescents with an average age of 14.6 years and comprising 53% boys. Compared to direct victims of an MVA in which someone was injured, witnesses of MVAs with injury reported significantly less internalizing symptoms, such as symptoms of posttraumatic stress (d = 0.25), fear (d = 0.21), and depression (d = 0.17). Compared to adolescents who were never exposed to an MVA with injury, witnesses reported significantly more externalizing symptoms (d = 0.24). In multiple regression analyses the significant difference between witnesses and victims disappeared when sex, other stressful events, appraisals, and coping were added to the model. These findings suggest that adolescent witnesses, as well as direct victims, may be at risk for posttraumatic reactions. Copyright © 2012 International Society for Traumatic Stress Studies.

  9. Posttraumatic stress disorder and traumatic stress: from bench to bedside, from war to disaster

    National Research Council Canada - National Science Library

    Ursano, Robert J; Goldenberg, Matthew; Zhang, Lei; Carlton, Janis; Fullerton, Carol S; Li, He; Johnson, Luke; Benedek, David

    2010-01-01

    War is a tragic event and its mental health consequences can be profound. Recent studies indicate substantial rates of posttraumatic stress disorder and other behavioral alterations because of war exposure...

  10. The impact of forensic investigations following assisted suicide on post-traumatic stress disorder.

    Science.gov (United States)

    Wagner, Birgit; Boucsein, Valerie; Maercker, Andreas

    2011-10-20

    In Switzerland, all deaths through assisted suicide are reported as unnatural deaths and investigated by a forensic team (police, medical examiner, and state attorney). However, there is limited knowledge concerning the impact these forensic investigations have on the development of post-traumatic stress disorder, complicated grief, or depression in those who have lost a loved one. A cross-sectional survey of 85 family members or close friends who were present at an assisted suicide was conducted in December 2007. The Impact of Event Scale, Inventory of Complicated Grief, and Brief Symptom Inventory were used to assess mental health. The newly developed Forensic Investigation Experience Scale measured the emotional experience of the legal investigation at the death scene. The data suggest that the diagnosis of post-traumatic stress disorder is significantly related to having experienced the forensic investigation as emotionally difficult. Thus, the way the forensic investigation is conducted immediately after an unnatural death is evidently associated with the development of post-traumatic stress. It is recommended that a protocol be developed establishing a standardised response to cases of assisted suicide and that specific training be provided for the legal professionals involved.

  11. Posttraumatic stress and posttraumatic growth among low-income mothers who survived Hurricane Katrina.

    Science.gov (United States)

    Lowe, Sarah R; Manove, Emily E; Rhodes, Jean E

    2013-10-01

    The purpose of the study was to explore the relationship between posttraumatic stress (PTS) and posttraumatic growth (PTG) after Hurricane Katrina, and the role of demographics, predisaster psychological distress, hurricane-related stressors, and psychological resources (optimism and purpose) in predicting each. Participants were 334 low-income mothers (82.0% non-Hispanic Black) living in the New Orleans area prior to Hurricane Katrina, who completed surveys in the year prior to the hurricane (T1 [Time 1]) and 1 and 3 years thereafter (T2 and T3). Higher T2 and T3 PTS full-scale and symptom cluster subscales (Intrusion, Avoidance, and Hyperarousal) were significantly associated with higher T3 PTG, and participants who surpassed the clinical cutoff for probable posttraumatic stress disorder at both T2 and T3 had significantly higher PTG than those who never surpassed the clinical cutoff. Older and non-Hispanic Black participants, as well as those who experienced a greater number of hurricane-related stressors and bereavement, reported significantly greater T3 PTS and PTG. Participants with lower T2 optimism reported significantly greater T3 intrusive symptoms, whereas those with higher T1 and T2 purpose reported significantly greater T3 PTG. Based on the results, we suggest practices and policies with which to identify disaster survivors at greater risk for PTS, as well as longitudinal investigations of reciprocal and mediational relationships between psychological resources, PTS, and PTG. (c) 2013 APA, all rights reserved.

  12. Post-traumatic stress disorder after car accidents.

    Science.gov (United States)

    Kuch, K; Swinson, R P; Kirby, M

    1985-10-01

    Survivors of car crashes often suffer from a post-traumatic fear of driving, generalized anxiety and depression. Unremitting pains are also common. As part of a pilot study 30 referred subjects were exposed to imagery of driving and accidents. Seventy-seven percent were phobic of driving. Fifty-three percent responded with increased anxiety to the imagery. Twelve treatment referrals received exposure therapy and six improved markedly. An additional four improved when a Benzodiazepine was added temporarily. Four out of eight subjects lost their unremitting pains along with their fears. When guided imagery evoked intense anxiety this seemed to predict a favourable outcome. A resumption of pleasure trips was a reliable criterion of recovery. The frequency of phobic symptomatology and it's importance to the understanding and management of post-traumatic anxiety states is discussed.

  13. Factors associated with post-traumatic stress symptoms among adolescents exposed to the Sewol ferry disaster in Korea.

    Science.gov (United States)

    Lee, Ju-Yeon; Kim, Sung-Wan; Bae, Kyung-Yeol; Kim, Jae-Min; Shin, Il-Seon; Yoon, Jin-Sang

    2017-10-01

    This study evaluated the factors associated with post-traumatic stress symptoms in Korean adolescents who lived in a disaster-affected community. A total of 1101 students attending secondary and high schools in Jindo, the location of the Sewol ferry disaster, were enrolled in a cross-sectional survey. The Child Report of Post-traumatic Symptoms (CROPS), the Center for Epidemiological Studies Depression Scale (CES-D), and the State Anxiety Inventory for Children (SAIC) were administered. Female gender, older children, poor academic achievement, and directly witnessing the rescue scene were associated with post-traumatic stress symptoms. The CES-D and SAIC scores of subjects with witness of the rescue were significantly higher than those of respondents without such experiences. The regression analysis revealed that directly witnessing the rescue scene was significantly associated with post-traumatic stress symptoms after adjusting for other variables. The results of this study suggest that witnessing the rescue scene following a disaster might be a risk factor for post-traumatic stress symptoms in adolescents in disaster-affected communities. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. World assumptions, posttraumatic stress and quality of life after a natural disaster: A longitudinal study

    Directory of Open Access Journals (Sweden)

    Nygaard Egil

    2012-06-01

    Full Text Available Abstract Background Changes in world assumptions are a fundamental concept within theories that explain posttraumatic stress disorder. The objective of the present study was to gain a greater understanding of how changes in world assumptions are related to quality of life and posttraumatic stress symptoms after a natural disaster. Methods A longitudinal study of 574 Norwegian adults who survived the Southeast Asian tsunami in 2004 was undertaken. Multilevel analyses were used to identify which factors at six months post-tsunami predicted quality of life and posttraumatic stress symptoms two years post-tsunami. Results Good quality of life and posttraumatic stress symptoms were negatively related. However, major differences in the predictors of these outcomes were found. Females reported significantly higher quality of life and more posttraumatic stress than men. The association between level of exposure to the tsunami and quality of life seemed to be mediated by posttraumatic stress. Negative perceived changes in the assumption “the world is just” were related to adverse outcome in both quality of life and posttraumatic stress. Positive perceived changes in the assumptions “life is meaningful” and “feeling that I am a valuable human” were associated with higher levels of quality of life but not with posttraumatic stress. Conclusions Quality of life and posttraumatic stress symptoms demonstrate differences in their etiology. World assumptions may be less specifically related to posttraumatic stress than has been postulated in some cognitive theories.

  15. Cognitive behavioral therapy for insomnia in posttraumatic stress disorder: a randomized controlled trial.

    Science.gov (United States)

    Talbot, Lisa S; Maguen, Shira; Metzler, Thomas J; Schmitz, Martha; McCaslin, Shannon E; Richards, Anne; Perlis, Michael L; Posner, Donn A; Weiss, Brandon; Ruoff, Leslie; Varbel, Jonathan; Neylan, Thomas C

    2014-02-01

    Examine whether cognitive behavioral therapy for insomnia (CBT-I) improves sleep in posttraumatic stress disorder (PTSD) as well as nightmares, nonsleep PTSD symptoms, depression symptoms, and psychosocial functioning. RANDOMIZED CONTROLLED TRIAL WITH TWO ARMS: CBT-I and monitor-only waitlist control. Department of Veterans Affairs (VA) Medical Center. Forty-five adults (31 females: [mean age 37 y (22-59 y)] with PTSD meeting research diagnostic criteria for insomnia, randomly assigned to CBT-I (n = 29; 22 females) or monitor-only waitlist control (n = 16; nine females). Eight-session weekly individual CBT-I delivered by a licensed clinical psychologist or a board-certified psychiatrist. Measures included continuous monitoring of sleep with diary and actigraphy; prepolysomnography and postpolysomnography and Clinician-Administered PTSD Scale (CAPS); and pre, mid, and post self-report questionnaires, with follow-up of CBT-I participants 6 mo later. CBT-I was superior to the waitlist control condition in all sleep diary outcomes and in polysomnography-measured total sleep time. Compared to waitlist participants, CBT-I participants reported improved subjective sleep (41% full remission versus 0%), disruptive nocturnal behaviors (based on the Pittsburgh Sleep Quality Index-Addendum), and overall work and interpersonal functioning. These effects were maintained at 6-mo follow-up. Both CBT-I and waitlist control participants reported reductions in PTSD symptoms and CAPS-measured nightmares. Cognitive behavioral therapy for insomnia (CBT-I) improved sleep in individuals with posttraumatic stress disorder, with durable gains at 6 mo. Overall psychosocial functioning improved following CBT-I. The initial evidence regarding CBT-I and nightmares is promising but further research is needed. Results suggest that a comprehensive approach to treatment of posttraumatic stress disorder should include behavioral sleep medicine. TRIAL NAME: Cognitive Behavioral Treatment Of Insomnia

  16. Posttraumatic Resilience in Former Ugandan Child Soldiers

    Science.gov (United States)

    Klasen, Fionna; Oettingen, Gabriele; Daniels, Judith; Post, Manuela; Hoyer, Catrin; Adam, Hubertus

    2010-01-01

    The present research examines posttraumatic resilience in extremely exposed children and adolescents based on interviews with 330 former Ugandan child soldiers (age = 11-17, female = 48.5%). Despite severe trauma exposure, 27.6% showed posttraumatic resilience as indicated by the absence of posttraumatic stress disorder, depression, and clinically…

  17. Posttraumatic Resilience in Former Ugandan Child Soldiers

    Science.gov (United States)

    Klasen, Fionna; Oettingen, Gabriele; Daniels, Judith; Post, Manuela; Hoyer, Catrin; Adam, Hubertus

    2010-01-01

    The present research examines posttraumatic resilience in extremely exposed children and adolescents based on interviews with 330 former Ugandan child soldiers (age = 11-17, female = 48.5%). Despite severe trauma exposure, 27.6% showed posttraumatic resilience as indicated by the absence of posttraumatic stress disorder, depression, and clinically…

  18. Childhood Trauma, Posttraumatic Stress Disorder, and Alcohol Dependence

    OpenAIRE

    Brady, Kathleen T.; Back, Sudie E.

    2012-01-01

    Early-childhood trauma is strongly associated with developing mental health problems, including alcohol dependence, later in life. People with early-life trauma may use alcohol to help cope with trauma-related symptoms. This article reviews the prevalence of early-childhood trauma and its robust association with the development of alcohol use disorders and posttraumatic stress disorder. It also examines the potential biological mechanisms by which early adverse experiences can result in long-...

  19. Diagnosing and treating post-traumatic stress disorder

    DEFF Research Database (Denmark)

    Buhmann, Cæcilie Böck; Andersen, Henrik Steen

    2017-01-01

    The post-traumatic stress disorder (PTSD) diagnosis has undergone large developments. With the changes in DSM-5 and the proposed changes in ICD-11, the two systems move in different directions. Treatment for PTSD is developing, but the evidence for the effect is lacking behind. Trauma-focused cog......-focused cognitive behavioural therapy and eye movement desensitization and reprocessing remain first choice. Pharmacotherapy is secondary. There is evidence for the effect of paroxetine, venlafaxine and fluoxetine and less so for sertraline....

  20. Predicting criminality from child maltreatment typologies and posttraumatic stress symptoms

    OpenAIRE

    Elklit, Ask; Armour, Cherie; Feddern, Dagmar; Christoffersen, Mogens; Karstoft, Karen-Inge

    2013-01-01

    Background: The associations between childhood abuse and subsequent criminality and posttraumatic stress disorder (PTSD) are well known. However, a major limitation of research related to childhood abuse and its effects is the focus on one particular type of abuse at the expense of others. Recent work has established that childhood abuse rarely occurs as a unidimensional phenomenon. Therefore, a number of studies have investigated the existence of abuse typologies.Methods: The study is based ...

  1. Disturbed family functioning in patients suffering from posttraumatic stress disorder.

    Science.gov (United States)

    Milenković, Tatjana; Simonović, Maja; Stanković, Miodrag; Samardžić, Ljiljana

    2013-02-01

    To investigate whether the presence of posttraumatic stress disorder (PTSD) symptomatology is related to specific family problems. The study included 94 subjects who were divided into three groups: a group with posttraumatic stress disorder (based on PCL for DSM-IV National Center for PTSD) (N=31), a group with problems in postwar functioning but without posttraumatic stress disorder (N=33), a group of subjects who were mobilized but with no combat exposure experience (N=30). The first and the second group had the experience of combat exposure. The first group was experimental, being diagnosed with PTSD. The second and the third group were control groups (the first and the second control group). The groups were compared by intensity and quality of family dysfunction, in relation to parameters, determined by specific instruments used in this research. The subjects with the experience of combat exposure had the problems in family functioning independently of the existence of PTSD diagnosis. Many of these problems were caused by the damage of combat experience. We also found a high level of secondary traumatization among other family members. The combat experience causes problems in postwar family functioning of combatants independently of PTSD diagnosis being confirmed. It is, therefore, necessary to help all of the combatants and their families reintegrate, regardless of their PTSD diagnosis.

  2. Post-traumatic stress disorder symptoms may explain poor mental health in patients with fibromyalgia.

    Science.gov (United States)

    Toussaint, Loren L; Whipple, Mary O; Vincent, Ann

    2015-10-20

    Symptoms of post-traumatic stress disorder are common in fibromyalgia patients. This study compared post-traumatic stress disorder symptoms in fibromyalgia patients and healthy controls and determined whether patient-control differences in post-traumatic stress disorder symptoms mediated differences in mental health. In all, 30 patients and 30 healthy controls completed questionnaires assessing symptoms of post-traumatic stress disorder and mental health. Fibromyalgia patients had greater symptoms of post-traumatic stress disorder and mental health than controls. Patient-control differences in mental health symptoms were fully or partially mediated by differences in post-traumatic stress disorder symptoms. Healthcare providers should understand the role of trauma as management of trauma symptoms may be one strategy for improving mental health.

  3. The prevalence of full and partial posttraumatic stress disorder among people with severe mental illness in Israel.

    Science.gov (United States)

    Gelkopf, Marc; Roe, David; Werbeloff, Nomi; Hasson-Ohayon, Ilanit; Mueser, Kim T; Caspi, Asaf; Weiser, Mark

    2013-03-01

    Research has shown higher rates of trauma exposure and posttraumatic stress disorder (PTSD) among persons with severe mental illness (SMI). The aim of this study was to assess the prevalence of traumatic events and full and partial PTSD among people with SMI and their associations with trauma-related cognitions and depressive symptoms. A total of 122 persons with SMI were assessed for trauma exposure and PTSD. A subsample of 40 participants, 20 with PTSD and 20 without PTSD, were randomly selected, and their posttraumatic cognitions and depressive symptoms were assessed. The prevalence of traumatic events was 90%, and 19% met full diagnostic criteria for PTSD, and 20% had partial PTSD. The people with PTSD had more depressive symptoms and negative cognitions. PTSD in SMI is highly prevalent and underdiagnosed.

  4. Posttraumatic Stress Disorder obesity and weight loss

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

    directional. The purpose of the present study was to examine whether the level of PTSD symptoms decrease as a result of weight loss in 30 obese participants during a 16 week stay at a weight loss facility. During the 16 weeks participants’ Body Mass Index (BMI) decreased significantly. Concurrently...... of depression also declined, whereas perceived social support was stable. The fact that the level of PTSD symptoms decreases simultaneously with weight loss is an interesting and positive side effect that has not been reported previously. The findings are discussed in term of cognitive theories of PTSD....

  5. The Role of Trauma-Specific Irrational Beliefs and Sociodemographic Risk Factors in Posttraumatic Stress Responses

    OpenAIRE

    Hyland, Philip; Shevlin, Mark; Adamson, Gary; Boduszek, Daniel

    2013-01-01

    Posttraumatic stress responses have been linked to a range of social-cognitive and sociodemographic factors. Rational Emotive Behaviour Therapy suggests that responding to a traumatic life event with a set of irrational beliefs should play a crucial role in predicting the development of posttraumatic stress disorder (PTSD: Ellis, 2001). The current study assessed the role of trauma-specific irrational beliefs in the prediction of clinically relevant posttraumatic stress responses, while contr...

  6. Brain structure in post-traumatic stress disorder A voxel-based morphometry analysis**

    Institute of Scientific and Technical Information of China (English)

    Liwen Tan; Li Zhang; Rongfeng Qi; Guangming Lu; Lingjiang Li; Jun Liu; Weihui Li

    2013-01-01

    This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, us-ing the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, fol owed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occip-ital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities.

  7. Brain structure in post-traumatic stress disorder: A voxel-based morphometry analysis.

    Science.gov (United States)

    Tan, Liwen; Zhang, Li; Qi, Rongfeng; Lu, Guangming; Li, Lingjiang; Liu, Jun; Li, Weihui

    2013-09-15

    This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, using the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occipital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities.

  8. Coping With Staff Burnout and Work-Related Posttraumatic Stress in Intensive Care.

    Science.gov (United States)

    Colville, Gillian A; Smith, Jared G; Brierley, Joe; Citron, Kim; Nguru, Noreen M; Shaunak, Priyanka D; Tam, Olivia; Perkins-Porras, Linda

    2017-07-01

    To examine the associations with symptoms of 1) burnout and 2) work-related posttraumatic stress, in adult and pediatric intensive care staff, focusing on the particular contributions of resilience and coping strategies. Point prevalence cross-sectional study. Three adult ICUs and four PICUs. Three hundred seventy-seven ICU staff. None. Brief Resilience Scale, abbreviated Maslach Burnout Inventory, Trauma Screening Questionnaire, and Hospital Anxiety and Depression Scale. Prevalence of burnout (defined as high emotional exhaustion or high depersonalization) was 37%. Prevalence of clinically significant posttraumatic stress symptoms was 13%. There was a degree of overlap between burnout and other measures of distress, most notably for anxiety (odds ratio, 10.56; 95% CI, 4.12-27.02; p < 0.001). Hierarchical logistic regression demonstrated that self-reported resilience was strongly associated with decreased likelihood of meeting criteria for both forms of work-related distress (burnout: odds ratio, 0.52; 95% CI, 0.36-0.74; p < 0.001 and posttraumatic stress: odds ratio, 0.28; 95% CI, 0.16-0.46; p < 0.001) and that physicians were twice as likely as nurses to be at risk of reporting burnout (odds ratio, 2.11; 95% CI, 1.18-3.78; p = 0.012). After controlling for resilience, profession, and setting, the following coping strategies were independently associated with outcomes: attending debriefing reduced risk of burnout (odds ratio, 0.45; 95% CI, 0.21-0.95; p = 0.036), whereas the odds of posttraumatic stress were less if staff used talking to seniors (odds ratio, 0.43; 95% CI, 0.20-0.92; p = 0.029) or hobbies (odds ratio, 0.46; 95% CI, 0.23-0.93; p = 0.030) to cope with stress at work. Venting emotion (odds ratio, 1.92; 95% CI, 1.12-3.31; p = 0.018) and using alcohol (odds ratio, 2.30; 95% CI, 1.26-4.20; p = 0.006) were associated with a doubling in risk of reporting burnout. The use of particular coping strategies was systematically associated with symptoms of burnout

  9. Prevalence rate of post-traumatic stress disorders (PTSD and other psychological disorders among Saudi firefighters

    Directory of Open Access Journals (Sweden)

    Mohammed Alghamd

    2013-08-01

    Full Text Available Background: Firefighters have a high probability of being exposed to a variety of traumatic events. Potentially traumatic events can occur during a single rescue such as: providing aid to seriously injured or helpless victims. Moreover, firefighters who are injured in the line of duty may have to retire as a consequence of their injury. The psychological cost of this exposure may increase the risk of long-term problems, such as post-traumatic stress disorder (PTSD symptoms, depression, and anxiety. Objective: The purpose of this study was to investigate the prevalence of PTSD symptoms, depression, anxiety, and assess related variables such as coping strategies and social support among Saudi firefighters. Method: Two hundred firefighters completed the Fire-fighter Trauma History Screen (FTHS to measure the number of traumatic events, Screen for Post-traumatic Stress Symptoms (SPTSS scale to assess the prevalence of PTSD symptoms, Hospital Anxiety and Depression Scales (HADS to assess depression and anxiety, Brief Cope (BC scale to measure coping strategies used, and Social Support scale was used to evaluate the firefighter's support received. Results: The results showed that 84% (169/200 of firefighters were exposed to at least one traumatic event. The result presented that 57% (96/169 of exposure firefighters fully met the DSM-IV criteria for PTSD with high levels of depression and anxiety; 39% (66/169 partially met the PTSD criteria. However, only 4% participants have not met the PTSD criteria. The results also revealed that adaptive coping strategies and higher perceived social support was associated with lower levels of PTSD. Conclusion: The high prevalence rate of PTSD related to the type and severity of the traumatic events and years of experience in the job. Accordingly, many firefighters were severely affected by their experiences, and we should be developing methods to help them.

  10. Acute post-traumatic stress symptoms and age predict outcome in military blast concussion.

    Science.gov (United States)

    Mac Donald, Christine L; Adam, Octavian R; Johnson, Ann M; Nelson, Elliot C; Werner, Nicole J; Rivet, Dennis J; Brody, David L

    2015-05-01

    High rates of adverse outcomes have been reported following blast-related concussive traumatic brain injury in US military personnel, but the extent to which such adverse outcomes can be predicted acutely after injury is unknown. We performed a prospective, observational study of US military personnel with blast-related concussive traumatic brain injury (n = 38) and controls (n = 34) enrolled between March and September 2012. Importantly all subjects returned to duty and did not require evacuation. Subjects were evaluated acutely 0-7 days after injury at two sites in Afghanistan and again 6-12 months later in the United States. Acute assessments revealed heightened post-concussive, post-traumatic stress, and depressive symptoms along with worse cognitive performance in subjects with traumatic brain injury. At 6-12 months follow-up, 63% of subjects with traumatic brain injury and 20% of controls had moderate overall disability. Subjects with traumatic brain injury showed more severe neurobehavioural, post-traumatic stress and depression symptoms along with more frequent cognitive performance deficits and more substantial headache impairment than control subjects. Logistic regression modelling using only acute measures identified that a diagnosis of traumatic brain injury, older age, and more severe post-traumatic stress symptoms provided a good prediction of later adverse global outcomes (area under the receiver-operating characteristic curve = 0.84). Thus, US military personnel with concussive blast-related traumatic brain injury in Afghanistan who returned to duty still fared quite poorly on many clinical outcome measures 6-12 months after injury. Poor global outcome seems to be largely driven by psychological health measures, age, and traumatic brain injury status. The effects of early interventions and longer term implications of these findings are unknown.

  11. Ideological commitment and posttraumatic stress in former Tamil child soldiers.

    Science.gov (United States)

    Kanagaratnam, Pushpa; Raundalen, Magne; Asbjørnsen, Arve E

    2005-12-01

    This study focuses on the impact of present ideological commitment on posttraumatic stress symptoms in former child soldiers living in exile. Eighteen men and two women (aged 25-37), who had joined different Tamil armed groups in Sri Lanka between the ages of 13 and 17 years, participated. The Impact of Event Scale was used to measure posttraumatic symptoms. Qualitative methods were used to investigate the participants' ideological commitment. Participants reported being exposed to many potentially traumatizing events, and had high scores on the Impact of Event Scale. Twenty-five percent of the sample showed strong ideological commitment to the "cause". Ideological commitment at the present seemed to predict better mental health when exposure was less intense and overwhelming. Time had a negative impact on ideological commitment.

  12. Post-Traumatic Stress Disorder (PDQ)

    Science.gov (United States)

    ... are helped by methods that teach them to change their behaviors by changing their thinking patterns. Through cognitive behavioral therapy (CBT), patients may be helped to: Understand their symptoms . Learn ways to cope and to manage stress (such as relaxation training ). Become aware of ...

  13. Metacognitive capacity predicts severity of trauma-related dysfunctional cognitions in adults with posttraumatic stress disorder.

    Science.gov (United States)

    Davis, Louanne W; Leonhardt, Bethany L; Siegel, Alysia; Brustuen, Beth; Luedtke, Brandi; Vohs, Jennifer L; James, Alison V; Lysaker, Paul H

    2016-03-30

    Deficits in metacognition have been proposed as a barrier to adaptive responding to trauma. However, little is known about how different aspects of metacognitive capacity relate to responses to trauma and whether their potential link to such responses is independent of the overall level of psychopathology. To explore both issues, negative trauma-related cognitions about the self, the world, and self-blame, as measured by the Posttraumatic Cognitions Inventory (PTCI), were correlated with concurrent measures of depression, posttraumatic stress disorder symptoms, and two forms of metacognition; the Metacognitions questionnaire (MCQ-30), which focuses on specific thoughts, and the Metacognition Assessment Scale Abbreviated (MAS-A) which focuses on the degree to which persons can form complex representations of self and other. Participants were 51 veterans of the wars in Iraq and Afghanistan who had a PTSD diagnosis primarily involving a combat-related index trauma. Correlations revealed that being younger and more depressed were linked with greater levels of negative cognitions about self and the world. Lower levels of self-reflectivity on the MAS-A and higher levels of cognitive self-consciousness on the MCQ-30 were uniquely related to greater levels of self-blame even after controlling for age, level of depression, and PTSD. Implications for research and treatment are discussed.

  14. Posttraumatic Stress Disorder (PTSD) and Disorders of Extreme Stress (DESNOS) symptoms following prostitution and childhood abuse.

    Science.gov (United States)

    Choi, Hyunjung; Klein, Carolin; Shin, Min-Sup; Lee, Hoon-Jin

    2009-08-01

    With the participation of 46 prostituted women in Korea, this study investigates the relationship between prostitution experiences, a history of childhood sexual abuse (CSA), and symptoms of posttraumatic stress disorder (PTSD) and disorders of extreme stress not otherwise specified (DESNOS). Prostituted women showed higher levels of PTSD and DESNOS symptoms compared to a control group. Women who had experienced both CSA by a significant other and prostitution showed the highest levels of traumatic stress. However, posttraumatic reexperiencing and avoidance and identity, relational, and affect regulation problems were significant for prostitution experiences even when the effects of CSA were controlled.

  15. Posttraumatic stress among women after induced abortion: a Swedish multi-centre cohort study

    Science.gov (United States)

    2013-01-01

    Background Induced abortion is a common medical intervention. Whether psychological sequelae might follow induced abortion has long been a subject of concern among researchers and little is known about the relationship between posttraumatic stress disorder (PTSD) and induced abortion. Thus, the aim of the study was to assess the prevalence of PTSD and posttraumatic stress symptoms (PTSS) before and at three and six months after induced abortion, and to describe the characteristics of the women who developed PTSD or PTSS after the abortion. Methods This multi-centre cohort study included six departments of Obstetrics and Gynaecology in Sweden. The study included 1457 women who requested an induced abortion, among whom 742 women responded at the three-month follow-up and 641 women at the six-month follow-up. The Screen Questionnaire-Posttraumatic Stress Disorder (SQ-PTSD) was used for research diagnoses of PTSD and PTSS, and anxiety and depressive symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS). Measurements were made at the first visit and at three and six months after the abortion. The 95% confidence intervals for the prevalence of lifetime or ongoing PTSD and PTSS were calculated using the normal approximation. The chi-square test and the Student’s t-test were used to compare data between groups. Results The prevalence of ongoing PTSD and PTSS before the abortion was 4.3% and 23.5%, respectively, concomitant with high levels of anxiety and depression. At three months the corresponding rates were 2.0% and 4.6%, at six months 1.9% and 6.1%, respectively. Dropouts had higher rates of PTSD and PTSS. Fifty-one women developed PTSD or PTSS during the observation period. They were young, less well educated, needed counselling, and had high levels of anxiety and depressive symptoms. During the observation period 57 women had trauma experiences, among whom 11 developed PTSD or PTSS and reported a traumatic experience in relation to the

  16. Factors associated with posttraumatic stress disorder symptoms among community volunteers during the Sewol ferry disaster in Korea.

    Science.gov (United States)

    Lee, Ju-Yeon; Kim, Sung-Wan; Bae, Kyung-Yeol; Kim, Jae-Min; Shin, Il-Seon; Yoon, Jin-Sang

    2017-08-01

    The aim of this study was to investigate the characteristics associated with volunteerism and identify the factors that contributed to posttraumatic stress disorder symptoms among community volunteers following the Sewol ferry disaster in Korea. In total, 2,298 adults (aged 30-70 years) from the Jin-do area, where the Sewol ferry disaster occurred, participated in this study. A cross-sectional survey was conducted 1 month after the disaster. Posttraumatic stress disorder (PTSD), depression, and anxiety symptoms were assessed using the Impact of Events Scale Revised (IES-R), Center for Epidemiologic Studies Depression Scale (CES-D), and Beck Anxiety Inventory (BAI). Clinically relevant PTSD symptoms were observed in 151 (19.7%) community volunteers. Age, education, socioeconomic status, religion, and lifetime experiences of natural disasters were associated with volunteering following the disaster. Logistic regression analysis revealed that volunteering was a significant risk factor for the development of PTSD symptoms in this sample. Personal experience with property damage associated with a traumatic event, depression, and anxiety were also significantly associated with the PTSD symptoms of community volunteers. Our results suggest the need for assessment and mental health programs for community volunteers performing rescue work to prevent posttraumatic stress symptoms following a community disaster. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Does Acute Stress Disorder Predict Posttraumatic Stress Disorder Following Bank Robbery?

    Science.gov (United States)

    Hansen, Maj; Elklit, Ask

    2013-01-01

    Unfortunately, the number of bank robberies is increasing and little is known about the subsequent risk of posttraumatic stress disorder (PTSD). Several studies have investigated the prediction of PTSD through the presence of acute stress disorder (ASD). However, there have only been a few studies following nonsexual assault. The present study…

  18. Gender Differences in Animal Models of Posttraumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Hagit Cohen

    2011-01-01

    Full Text Available Epidemiological studies report higher prevalence rates of stress-related disorders such as acute stress disorder and post-traumatic stress disorder (PTSD in women than in men following exposure to trauma. It is still not clear whether this greater prevalence in woman reflects a greater vulnerability to stress-related psychopathology. A number of individual and trauma-related characteristics have been hypothesized to contribute to these gender differences in physiological and psychological responses to trauma, differences in appraisal, interpretation or experience of threat, coping style or social support. In this context, the use of an animal model for PTSD to analyze some of these gender-related differences may be of particular utility. Animal models of PTSD offer the opportunity to distinguish between biological and socio-cultural factors, which so often enter the discussion about gender differences in PTSD prevalence.

  19. Psychogenetics of post-traumatic stress disorder: a short review

    Directory of Open Access Journals (Sweden)

    Ahmed Rady

    2010-11-01

    Full Text Available Ahmed Rady, Adel Elsheshai, Osama Elkholy, Heba Abou el WafaDepartment of Psychiatry, Alexandria University, Alexandria, EgyptAbstract: Post-traumatic stress disorder is a commonly overlooked psychiatric disorder due to the heterogeneity of symptoms that may simulate many other psychiatric disorders. Such heterogeneity of manifestations may be explained by the multifaceted nature of the different neurotransmitters, endocrinologic axis, and their genetic basis, that are implicated in the etiology. Although this disorder has been studied from many different perspectives, its etiology is still enigmatic. This minireview demonstrates, in brief, that different susceptibility genes are associated with post traumatic stress disorder.Keywords: trauma, post traumatic stress disorder, psychogenetic, stress response, neurobiology

  20. Youth offspring of mothers with posttraumatic stress disorder have altered stress reactivity in response to a laboratory stressor.

    Science.gov (United States)

    Danielson, Carla Kmett; Hankin, Benjamin L; Badanes, Lisa S

    2015-03-01

    Parental Posttraumatic Stress Disorder (PTSD), particularly maternal PTSD, confers risk for stress-related psychopathology among offspring. Altered hypothalamic-pituitary-adrenal (HPA) axis functioning is one mechanism proposed to explain transmission of this intergenerational risk. Investigation of this mechanism has been largely limited to general stress response (e.g., diurnal cortisol), rather than reactivity in response to an acute stressor. We examined cortisol reactivity in response to a laboratory stressor among offspring of mothers with a lifetime diagnosis of PTSD (n=36) and age- and gender- matched control offspring of mothers without PTSD (n=36). Youth (67% girls; mean age=11.4, SD=2.6) participated in a developmentally sensitive laboratory stressor and had salivary cortisol assessed five times (one pre-stress, one immediate post-stress, and three recovery measures, spaced 15min apart). Results were consistent with the hypothesis that offspring of mothers with PTSD would exhibit a dysregulated, blunted cortisol reactivity profile, and control offspring would display the expected adaptive peak in cortisol response to challenge profile. Findings were maintained after controlling for youth traumatic event history, physical anxiety symptoms, and depression, as well as maternal depression. This finding contributes to the existing literature indicating that attenuated HPA axis functioning, inclusive of hyposecretion of cortisol in response to acute stress, is robust among youth of mothers with PTSD. Future research is warranted in elucidating cortisol reactivity as a link between maternal PTSD and stress-related psychopathology vulnerability among offspring.

  1. Posttraumatic stress symptomatology among emergency department workers following workplace aggression.

    Science.gov (United States)

    Gillespie, Gordon Lee; Bresler, Scott; Gates, Donna M; Succop, Paul

    2013-06-01

    Workplace aggression has the potential to adversely affect the psychological health of emergency department (ED) workers. The purpose of this study was to compare posttraumatic stress symptomatology based on verbal and verbal plus physical aggression. A descriptive cross-sectional design was used with a convenience sample (n = 208) of ED workers who completed a three-component survey. Descriptive statistics were computed to compare traumatic stress scores based on type of aggression. Two-way analysis of variance statistics were computed to determine if scores differed on the demographic variables. Fewer than half of the ED workers reported traumatic stress symptomatology; however, workplace aggression has the potential to adversely affect the mental health of ED workers. Occupational health nurses can establish or maintain a nurturing and protective environment open to discussing the personal thoughts, feelings, and behaviors of ED workers related to their experiences of workplace aggression. This open and more positive work environment may aid in reducing the negative impact of posttraumatic stress symptoms among those ED workers who have been victimized.

  2. The relationship between posttraumatic stress symptoms and suicide ideation among child survivors following the Wenchuan earthquake.

    Science.gov (United States)

    Ying, Liuhua; Chen, Chuansheng; Lin, Chongde; Greenberger, Ellen; Wu, Xinchun; Jiang, Lina

    2015-04-01

    The association between posttraumatic stress disorder (PTSD) symptoms and suicide ideation was examined in a sample of 2,298 child survivors of the Wenchuan earthquake. Results indicated that intrusion, avoidance, hyperarousal symptom clusters, and PTSD total score were significantly associated with suicide ideation. Except for intrusion, other measures of PTSD remained as statistically significant correlates of suicide ideation even after controlling for age, gender, direct exposure, indirect exposure, and depression. Furthermore, results showed that PTSD symptoms had an indirect influence on suicide ideation that was mediated by depression. The findings suggest that avoidance and hyperarousal symptom clusters of PTSD may be two important indicators of suicide ideation among child survivors of the Wenchuan earthquake. Implications of the results for intervention and prevention of suicide behavior are discussed.

  3. Elevated C-reactive protein and posttraumatic stress pathology among survivors of the 9/11 World Trade Center attacks.

    Science.gov (United States)

    Rosen, Rebecca L; Levy-Carrick, Nomi; Reibman, Joan; Xu, Ning; Shao, Yongzhao; Liu, Mengling; Ferri, Lucia; Kazeros, Angeliki; Caplan-Shaw, Caralee E; Pradhan, Deepak R; Marmor, Michael; Galatzer-Levy, Isaac R

    2017-06-01

    Systemic inflammation has emerged as a promising marker and potential mechanism underlying post-traumatic stress disorder (PTSD). The relationship between posttraumatic stress pathology and systemic inflammation has not, however, been consistently replicated and is potentially confounded by comorbid illness or injury, common complications of trauma exposure. We analyzed a large naturalistic cohort sharing a discrete physical and mental health trauma from the destruction of the World Trade Center (WTC) towers on September 11, 2001 (n = 641). We evaluated the relationship between multiple physical and mental health related indices collected through routine evaluations at the WTC Environmental Health Center (WTC EHC), a treatment program for community members exposed to the disaster. C-Reactive Protein (CRP), a marker of systemic inflammation, was examined in relation to scores for PTSD, PTSD symptom clusters (re-experiencing, avoidance, negative cognitions/mood, arousal), depression and anxiety, while controlling for WTC exposures, lower respiratory symptoms, age, sex, BMI and smoking as potential risks or confounders. CRP was positively associated with PTSD severity (p < 0.001), trending toward association with depression (p = 0.06), but not with anxiety (p = 0.27). CRP was positively associated with re-experiencing (p < 0.001) and avoidance (p < 0.05) symptom clusters, and trended toward associations with negative cognitions/mood (p = 0.06) and arousal (p = 0.08). In this large study of the relationship between CRP and posttraumatic stress pathology, we demonstrated an association between systemic inflammation and stress pathology (PTSD; trending with depression), which remained after adjusting for potentially confounding variables. These results contribute to research findings suggesting a salient relationship between inflammation and posttraumatic stress pathology. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Can we predict intensive care relatives at risk for posttraumatic stress disorder?

    Directory of Open Access Journals (Sweden)

    Pillai Lalitha

    2010-01-01

    Full Text Available Aims: To identify the relatives of the intensive care unit (ICU patients at risk for developing symptoms of posttraumatic stress disorders. Setting: A multidisciplinary hospital ICU. Design: Prospective single center observational study. Material and Methods: Relatives of patients admitted in the ICU (May06-Nov06 who consented to answer the questionnaire participated in the study. Anxiety was assessed by using the Hospital Anxiety and Depression Scale (HAD and vulnerability to posttraumatic disorder (PTSD by using the Impact of Event Scale Revised (IES-R which was administered on the fifth day of admission and at two months following discharge or death. Results: During admission, 48% of the relatives had a HAD score >11 and 72% showed IES-R score >26. There was no association of HAD with gender, patient outcome, working status, age of the patient, or mode of payment of the bills. There was significant association of IES-R >26 with trauma admission, HAD score >11 and mode of payment with the relatives of insured being more stressed as compared to those who settled their bills personally. A total of 35% relatives showed symptoms of posttraumatic stress reaction consistent with a high risk of PTSD after two months. Death in the hospital resulted in elevated HAD and IES-R score during admission and at the two month follow-up. Persistence of stress symptoms was more in school drop outs, working relatives, parents and those with initial anxiety score >11. Conclusions: HAD score greater than 11 was the only factor at admission which could statistically predict a higher PTSD score on follow-up. Adequate counseling of this group of relatives may prevent lasting psychological sequelae of an ICU admission in the relatives of critically ill.

  5. New drug development for post-traumatic stress disorder.

    Science.gov (United States)

    Berlant, Jeffrey

    2003-01-01

    US FDA approval of two serotonin-selective reuptake inhibitor (SSRI) agents for post-traumatic stress disorder (PTSD) has created new opportunities for drug development. This follows many years of exploring the potential utility of several classes of psychotropic agents for this very common, yet under-recognized and under-treated disorder. This review examines some of the basic neurobiological abnormalities observed in PTSD and summarizes open and controlled drug trials for major classes of medications, including SSRIs, other antidepressants, atypical neuroleptics, noradrenergic modulators and anticonvulsants, while critically evaluating the extent of effectiveness of these agents and reviewing unmet gaps in therapeutic need.

  6. Post-traumatic stress disorder: theory and treatment update.

    Science.gov (United States)

    Kirkpatrick, Heather A; Heller, Grant M

    2014-01-01

    Post-traumatic stress disorder (PTSD) is one of the few mental disorders in which the cause is readily identifiable. In this article, we review the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria, prevalence, and presentation of patients with PTSD in primary care. The purpose of this article is to review current literature regarding theory, etiology, and treatment effectiveness. Key findings in terms of neurobiological underpinnings with implications for future treatment are discussed. Recommendations regarding effective psychotherapy and pharmacotherapy, emerging treatment, and management issues in primary care settings are offered.

  7. A memory-based model of posttraumatic stress disorder

    DEFF Research Database (Denmark)

    Rubin, David C.; Berntsen, Dorthe; Johansen, Marlene Klindt

    2008-01-01

    In the mnemonic model of posttraumatic stress disorder (PTSD), the current memory of a negative event, not the event itself, determines symptoms. The model is an alternative to the current event-based etiology of PTSD represented in the Diagnostic and Statistical Manual of Mental Disorders (4th ed....... Predisposing factors that affect the current memory have large effects on symptoms. The inability-to-recall-an-important-aspect-of-the-trauma symptom does not correlate with other symptoms. Loss or enhancement of the trauma memory affects PTSD symptoms in predictable ways. Special mechanisms that apply only...

  8. ANIMAL MODELS OF POST-TRAUMATIC STRESS DISORDER: FACE VALIDITY

    Directory of Open Access Journals (Sweden)

    SONAL eGOSWAMI

    2013-05-01

    Full Text Available Post-traumatic stress disorder (PTSD is a debilitating condition that develops in a proportion of individuals following a traumatic event. Despite recent advances, ethical limitations associated with human research impede progress in understanding PTSD. Fortunately, much effort has focused on developing animal models to help study the pathophysiology of PTSD. Here, we provide an overview of animal PTSD models where a variety of stressors (physical, psychosocial, or psychogenic are used to examine the long-term effects of severe trauma. We emphasize models involving predator threat because they reproduce human individual differences in susceptibility to, and in the long-term consequences of, psychological trauma.

  9. Posttraumatic stress disorder: a primer for trauma surgeons.

    Science.gov (United States)

    Roberts, Jennifer C; deRoon-Cassini, Terri A; Brasel, Karen J

    2010-07-01

    In 1980, posttraumatic stress disorder (PTSD) officially became classified as an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition. Since then, there has been increasing recognition that PTSD is a prevalent disorder that may have significant impact on the quality of life for survivors of traumatic events. More recently, methodologically sound research has begun to provide important insight into this disorder. The following review serves to provide the trauma surgeons information on PTSD in terms of its diagnosis, prevalence, risk factors, treatment strategies, and outcomes, with the goal of minimizing the sequelae of PTSD and maximizing postinjury quality of life.

  10. Interdisciplinary residential treatment of posttraumatic stress disorder and traumatic brain injury: effects on symptom severity and occupational performance and satisfaction.

    Science.gov (United States)

    Speicher, Sarah M; Walter, Kristen H; Chard, Kathleen M

    2014-01-01

    OBJECTIVE. This study examined outcomes of an 8-wk residential treatment program for veterans with posttraumatic stress disorder (PTSD) and a history of traumatic brain injury (TBI). METHOD. Twenty-six veterans completed the Canadian Occupational Performance Measure, Clinician-Administered PTSD Scale, Beck Depression Inventory-2nd Edition, and PTSD Checklist before and after treatment. RESULTS. Veterans demonstrated significant improvements in occupational performance and satisfaction with their performance, as well as in PTSD and depression symptom severity after residential PTSD/TBI treatment. Additionally, improvements in occupational performance and satisfaction were associated with decreases in depression symptom severity. CONCLUSION. Although preliminary, results suggest that veterans with PTSD and a history of TBI experienced significant decreases in PTSD and depression symptom severity and improvement in self-perception of performance and satisfaction in problematic occupational areas. Changes in occupational areas and depression symptom severity were related, highlighting the importance of interdisciplinary treatment. Copyright © 2014 by the American Occupational Therapy Association, Inc.

  11. Self-reported posttraumatic growth predicts greater subsequent posttraumatic stress amidst war and terrorism.

    Science.gov (United States)

    Zalta, Alyson K; Gerhart, James; Hall, Brian J; Rajan, Kumar B; Vechiu, Catalina; Canetti, Daphna; Hobfoll, Stevan E

    2017-03-01

    This study tested three alternative explanations for research indicating a positive, but heterogeneous relationship between self-reported posttraumatic growth (PTG) and posttraumatic stress symptoms (PSS): (a) the third-variable hypothesis that the relationship between PTG and PSS is a spurious one driven by positive relationships with resource loss, (b) the growth over time hypothesis that the relationship between PTG and PSS is initially a positive one, but becomes negative over time, and (c) the moderator hypothesis that resource loss moderates the relationship between PTG and PSS such that PTG is associated with lower levels of PSS as loss increases. A nationally representative sample (N = 1622) of Israelis was assessed at three time points during a period of ongoing violence. PTG, resource loss, and the interaction between PTG and loss were examined as lagged predictors of PSS to test the proposed hypotheses. Results were inconsistent with all three hypotheses, showing that PTG positively predicted subsequent PSS when accounting for main and interactive effects of loss. Our results suggest that self-reported PTG is a meaningful but counterintuitive predictor of poorer mental health following trauma.

  12. Psychological wellbeing and posttraumatic stress associated with implantable cardioverter defibrillator therapy in young adults with genetic heart disease.

    Science.gov (United States)

    Ingles, Jodie; Sarina, Tanya; Kasparian, Nadine; Semsarian, Christopher

    2013-10-09

    Sudden cardiac death is a tragic complication of a number of genetic heart diseases. Implantable cardioverter defibrillator (ICD) therapy plays an important role in prevention of sudden death. The psychological consequences of ICD therapy in young people with genetic heart disease are poorly understood. This study sought to better understand psychological wellbeing and identify symptoms of posttraumatic stress in young people who had experienced an ICD shock. Eligible patients (ICD implanted over 12 months prior) with an inherited cardiomyopathy or primary arrhythmogenic disorder, enrolled in the Australian Genetic Heart Disease Registry were included. Ninety patients completed the Hospital Anxiety and Depression Scale (HADS). Those patients who had an ICD shock (n=31) also completed the Impact of Events Scale-Revised (IES-R). While the mean HADS-Anxiety and IES-R scores were within the normal range in the total group (n=90), a significant subgroup reported symptoms of anxiety (38%), depression (17%) and posttraumatic stress (31%) indicative of the potential need for referral to clinical care. Overall, greater psychological distress in ICD patients was associated with female gender, a history of syncope, other comorbid medical conditions, and reporting of other distressing events (i.e., ICD complications). In those with an ICD shock, higher posttraumatic stress scores were associated with female gender and longer time to first shock. Patients with genetic heart diseases can experience psychological difficulties, including anxiety, depression and posttraumatic stress, related to ICD implantation and subsequent shocks. This signals the importance of offering patients access to targeted interventions, including psychological care and support. © 2013.

  13. Exercise for Stress and Anxiety

    Science.gov (United States)

    ... Disorder Specific Phobias Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) Depression Bipolar Disorder Suicide and Prevention Stress Related Illnesses Myth-Conceptions Find ...

  14. EMDR for Syrian refugees with posttraumatic stress disorder symptoms: results of a pilot randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ceren Acarturk

    2015-05-01

    Full Text Available Background: The most common mental health problems among refugees are depression and posttraumatic stress disorder (PTSD. Eye movement desensitization and reprocessing (EMDR is an effective treatment for PTSD. However, no previous randomized controlled trial (RCT has been published on treating PTSD symptoms in a refugee camp population. Objective: Examining the effect of EMDR to reduce the PTSD and depression symptoms compared to a wait-list condition among Syrian refugees. Method: Twenty-nine adult participants with PTSD symptoms were randomly allocated to either EMDR sessions (n=15 or wait-list control (n=14. The main outcome measures were Impact of Event Scale-Revised (IES-R and Beck Depression Inventory (BDI-II at posttreatment and 4-week follow-up. Results: Analysis of covariance showed that the EMDR group had significantly lower trauma scores at posttreatment as compared with the wait-list group (d=1.78, 95% CI: 0.92–2.64. The EMDR group also had a lower depression score after treatment as compared with the wait-list group (d=1.14, 95% CI: 0.35–1.92. Conclusion: The pilot RCT indicated that EMDR may be effective in reducing PTSD and depression symptoms among Syrian refugees located in a camp. Larger RCTs to verify the (cost- effectiveness of EMDR in similar populations are needed.

  15. The Incremental Validity and Clinical Utility of the MMPI-2 Infrequency Posttraumatic Stress Disorder Scale

    Science.gov (United States)

    Marshall, Margarita B.; Bagby, R. Michael

    2006-01-01

    The incremental validity and clinical utility of the recently developed Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Infrequency Posttraumatic Stress Disorder Scale (Fptsd) was examined in relation to the family of MMPI-2 F scales in distinguishing feigned post-traumatic stress disorder (PTSD) from disability claimants with PTSD.…

  16. The Mutual Prospective Influence of Child and Parental Post-Traumatic Stress Symptoms in Pediatric Patients

    Science.gov (United States)

    Landolt, Markus A.; Ystrom, Eivind; Sennhauser, Felix H.; Gnehm, Hanspeter E.; Vollrath, Margarete E.

    2012-01-01

    Background: Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study…

  17. The Mutual Prospective Influence of Child and Parental Post-Traumatic Stress Symptoms in Pediatric Patients

    Science.gov (United States)

    Landolt, Markus A.; Ystrom, Eivind; Sennhauser, Felix H.; Gnehm, Hanspeter E.; Vollrath, Margarete E.

    2012-01-01

    Background: Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study…

  18. Analysis of Suicidal Behaviour in Israeli Veterans and Terror Victims with Post-Traumatic Stress Disorder by Using the Computerised Gottschalk-Gleser Scales

    Science.gov (United States)

    Galor, Sharon; Hentschel, Uwe

    2009-01-01

    The primary objective of this study was to identify the vulnerability factors for suicide attempts in an Israeli sample, with the help of the Gottschalk-Gleser content analysis scales. The respondents were divided into four groups: suicide attempters; controls; post-traumatic stress disorder and depressed patients who did not report suicidal…

  19. Changes in Galanin Systems in a Rat Model of Post-Traumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Barnabas, Karen; Zhang, Lin; Wang, Huiying; Kirouac, Gilbert; Vrontakis, Maria

    2016-01-01

    Post-traumatic stress disorder (PTSD) is a chronic syndrome triggered by exposure to trauma and a failure to recover from a normal negative emotional reaction to traumatic stress. The neurobiology of PTSD and the participation of neuropeptides in the neural systems and circuits that control fear and anxiety are not fully understood. The long-term dysregulation of neuropeptide systems contributes to the development of anxiety disorders, including PTSD. The neuropeptide galanin (Gal) and its receptors participate in anxiety-like and depression-related behaviors via the modulation of neuroendocrine and monoaminergic systems. The objective of this research was to investigate how Gal expression changes in the brain of rats 2 weeks after exposure to footshock. Rats exposed to footshocks were subdivided into high responders (HR; immobility>60%) and low responders (LR; immobilityanxiety and PTSD development.

  20. Posttraumatic Stress Disorder and Acute Stress Disorder II: Considerations for Treatment and Prevention

    OpenAIRE

    2005-01-01

    Posttraumatic stress disorder is a common and often chronic and disabling anxiety disorder that can develop after exposure to highly stressful events characterized by actual or threatened harm to the self or others. This is the second of two invited articles summarizing the nature and treatment of PTSD and the associated condition of acute stress disorder (ASD). The present article reviews evidence for the efficacy of psychological and pharmacological treatments for PTSD and ASD. In summary, ...

  1. The relationship between forgiveness, spirituality, traumatic guilt and posttraumatic stress disorder (PTSD) among people with addiction.

    Science.gov (United States)

    Langman, Louise; Chung, Man Cheung

    2013-03-01

    Spirituality and forgiveness have been shown to be associated with psychological well-being, while guilt has been associated with poor health. Little is known, however, about the relationship between forgiveness, spirituality, guilt, posttraumatic stress (PTSD) and psychological co-morbidity among people in recovery from addiction. Eighty-one people (F = 36, M = 45) in recovery from drug and alcohol addiction were recruited from two residential units and two drop-in centres in a city in the United Kingdom. They completed the Posttraumatic Stress Diagnostic Scale (PDS), the General Health Questionnaire-28 (GHQ-28), the Spiritual Involvement and Beliefs Scale (SIBS), the Heartland Forgiveness Scale (HFS), the Traumatic Guilt Inventory (TGI), the Michigan Alcoholism Screening Test (MAST-22) and the Drug Abuse Screening Test (DAST-20). The control group comprised of 83 (F = 34, M = 49) individuals who confirmed that they did not have addiction and completed the PDS & GHQ-28. 54 % of the addiction group met the criteria for full PTSD and reported anxiety, somatic problems and depression. They described themselves as spiritual, had strong feelings of guilt associated with their addiction, and had difficulty in forgiving themselves. Controlling for demographics, number of events and medication management, regression analyses showed that spirituality predicted psychological co-morbidity, whilst feelings of guilt predicted PTSD symptoms and psychological co-morbidity. Unexpectedly, forgiveness did not predict outcomes. This study supports existing literature, which shows that people with drug and alcohol addiction tend to have experienced significant past trauma and PTSD symptoms. Their posttraumatic stress reactions and associated psychological difficulties can be better understood in the light of guilt and spirituality. Meanwhile, their ability to forgive themselves or others did not seem to influence health outcomes.

  2. Harm expectancy violation during exposure therapy for posttraumatic stress disorder.

    Science.gov (United States)

    de Kleine, Rianne A; Hendriks, Lotte; Becker, Eni S; Broekman, Theo G; van Minnen, Agnes

    2017-06-01

    Exposure therapy has proven efficacy in the treatment of posttraumatic stress disorder (PTSD). Emotional processing theory proposes that fear habituation is a central mechanism in symptom reduction, but the empirical evidence supporting this is mixed. Recently it has been proposed that violation of harm expectancies is a crucial mechanism of action in exposure therapy. But to date, changes in harm expectancies have not been examined during exposure therapy in PTSD. The goal of the current study was to examine harm expectancy violation as mechanism of change in exposure therapy for posttraumatic stress disorder (PTSD). Patients (N=50, 44 female) with a primary diagnosis of chronic PTSD received intensive exposure therapy. Harm expectancies, harm experiences and subjective units of distress (SUDs) were assessed at each imaginal exposure session, and PTSD symptoms were assessed pre- and posttreatment with the Clinician Administered PTSD Scale (CAPS). Results showed that harm expectancies were violated within and strongly declined in-between exposure therapy sessions. However, expectancy violation was not related to PTSD symptom change. Fear habituation measures were moderately related to PTSD symptom reductions. In line with theory, exposure therapy promotes expectancy violation in PTSD patients, but this is not related to exposure therapy outcome. More work is warranted to investigate mechanisms of change during exposure therapy in PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Complex posttraumatic stress disorder and survivors of human rights violations.

    Science.gov (United States)

    McDonnell, Matthew; Robjant, Katy; Katona, Cornelius

    2013-01-01

    This article reviews recent findings on Complex Posttraumatic Stress Disorder (CPTSD) and proposes future research which would help to establish the nature of CPTSD in relation to Posttraumatic Stress Disorder (PTSD). Research on survivors of torture and war has found that CPTSD can occur when there is no history of childhood abuse. fMRI studies appear to highlight differences in neural activity in individuals exhibiting primary dissociation compared with individuals exhibiting secondary dissociation. Research has begun to show that, when symptoms of secondary dissociation are appropriately managed, exposure-based therapies are an effective treatment for individuals with CPTSD. Much research on CPTSD has emphasized its developmental basis and the disruptive effects of trauma in childhood and adolescence on subsequent emotional development. However, some studies on survivors of torture in adult life identify similar symptom patterns, despite there being no history of childhood trauma. It is argued that comparative research is required between victims of developmental trauma (such as childhood sexual abuse) and victims who experienced prolonged interpersonal trauma in adulthood (such as torture), as this could be useful in establishing the cause of CPTSD and in delineating clinically and therapeutically meaningful subtypes. It is also proposed that a focus on underlying neurobiological processes would help in developing and refining CPTSD as a construct and informing treatment.

  4. Posttraumatic stress in children with first responders in their families.

    Science.gov (United States)

    Duarte, Cristiane S; Hoven, Christina W; Wu, Ping; Bin, Fan; Cotel, Sivan; Mandell, Donald J; Nagasawa, Megumi; Balaban, Victor; Wernikoff, Linda; Markenson, David

    2006-04-01

    High levels of exposure and occupational stress of first responders may have caused children in first-responder families to become traumatized following the September 11th, 2001 terrorist attacks. New York City public school children (N = 8,236) participated in a study examining mental health problems 6 months after the World Trade Center attack. Results revealed that children with emergency medical technician (EMT) family members had a high prevalence of probable posttraumatic stress disorder (PTSD; 18.9%). Differences in rates of probable PTSD among EMTs' and firefighters' children were explained by demographic characteristics. Where EMTs are drawn from disadvantaged groups, one implication of this study is to target EMT families in any mental health interventions for children of first responders.

  5. Who Develops Posttraumatic Stress Symptoms Following a Bank Robbery?

    DEFF Research Database (Denmark)

    Hansen, Maj; Elklit, Ask

    2014-01-01

    or self-selecting samples. To overcome these limitations, we investigated the estimated prevalence rate of acute stress disorder (ASD) and PTSD and predictors of PTSD severity in a Danish cohort study of all bank employees exposed to robbery during one year (N = 614). A total of 450 employees (73......Each year, numerous bank robberies take place worldwide. Even so, only few studies have investigated the psychological sequelae of bank robbery and little is known about the risk factors associated with the development of posttraumatic stress disorder (PTSD) following this potentially traumatic...... event. Knowledge about risk factors related to PTSD may allow for preventive measures to be taken against the development of PTSD and reduce the large cost associated with the disorder. Furthermore, the few existing studies are characterized by several limitations such as the use of small convenience...

  6. Who Develops Posttraumatic Stress Symptoms Following a Bank Robbery?

    DEFF Research Database (Denmark)

    Hansen, Maj; Elklit, Ask

    2014-01-01

    Each year, numerous bank robberies take place worldwide. Even so, only few studies have investigated the psychological sequelae of bank robbery and little is known about the risk factors associated with the development of posttraumatic stress disorder (PTSD) following this potentially traumatic...... event. Knowledge about risk factors related to PTSD may allow for preventive measures to be taken against the development of PTSD and reduce the large cost associated with the disorder. Furthermore, the few existing studies are characterized by several limitations such as the use of small convenience...... or self-selecting samples. To overcome these limitations, we investigated the estimated prevalence rate of acute stress disorder (ASD) and PTSD and predictors of PTSD severity in a Danish cohort study of all bank employees exposed to robbery during one year (N = 614). A total of 450 employees (73...

  7. Posttraumatic stress in intensive care unit survivors - a prospective study

    DEFF Research Database (Denmark)

    Ratzer, Mette; Brink, Ole; Knudsen, Linda

    2014-01-01

    Aims: This study aimed to estimate the prevalence of severe Posttraumatic Stress Disorder (PTSD) symptoms and to identify factors associated with PTSD in survivors of intensive care unit (ICU) treatment following traumatic injury. Methods: Fifty-two patients who were admitted to an ICU through...... the emergency ward following traumatic injury were prospectively followed. Information on injury severity and ICU treatment were obtained through medical records. Demographic information and measures of acute stress symptoms, experienced social support, coping style, sense of coherence (SOC) and locus...... of control were assessed within one-month post-accident (T1). At the six months follow-up (T2), PTSD was assessed with the Harvard Trauma Questionnaire (HTQ). Results: In the six months follow-up, 10 respondents (19.2%) had HTQ total scores reaching a level suggestive of PTSD (N = 52), and 11 respondents (21...

  8. Risk factors for antenatal depression, postnatal depression and parenting stress

    Directory of Open Access Journals (Sweden)

    Milgrom Jeannette

    2008-04-01

    Full Text Available Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Methods Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26–32 weeks gestation. A subsample of these women (N = 161 also completed questionnaires at 10–12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI. Results Regression analyses identified significant risk factors for the three outcome measures. (1. Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2. Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3. Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator

  9. Risk factors for antenatal depression, postnatal depression and parenting stress.

    Science.gov (United States)

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-04-16

    Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26-32 weeks gestation. A subsample of these women (N = 161) also completed questionnaires at 10-12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI). Regression analyses identified significant risk factors for the three outcome measures. (1). Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2). Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3). Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator for other risk factors. Risk factor profiles for

  10. The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: A prospective study.

    NARCIS (Netherlands)

    Engelhard, I.M.; van den Hout, M.; Kindt, M.

    2003-01-01

    The personality trait of Neuroticism has been repeatedly associated with symptoms of post-traumatic stress disorder (PTSD). However, the nature of this relationship is unclear. There are at least two possible interpretations: neuroticism might be a risk factor for PTSD symptoms, or, alternatively,

  11. The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: A prospective study.

    NARCIS (Netherlands)

    Engelhard, I.M.; van den Hout, M.; Kindt, M.

    2003-01-01

    The personality trait of Neuroticism has been repeatedly associated with symptoms of post-traumatic stress disorder (PTSD). However, the nature of this relationship is unclear. There are at least two possible interpretations: neuroticism might be a risk factor for PTSD symptoms, or, alternatively, t

  12. Predictors of posttraumatic stress disorder among police officers: A prospective study.

    Science.gov (United States)

    Marchand, André; Nadeau, Céline; Beaulieu-Prévost, Dominic; Boyer, Richard; Martin, Mélissa

    2015-05-01

    This prospective study examined risk and protective factors in the development of posttraumatic stress disorder (PTSD) in a sample of 83 police officers. Structured interviews were conducted in order to assess the most recent work-related traumatic event and establish diagnoses of acute stress disorder (ASD) and full or partial PTSD. Police officers were assessed between 5 and 15 days, and at 1 month, 3 months, and 12 months after the event. They also completed self-administered questionnaires assessing several potential predictors. Predictive analyses about the onset of PTSD were based on a 4-step nested random-effect linear regression. Overall, results showed that the modulation of PTSD symptomatology was associated with some pretraumatic (i.e., emotional coping strategies and number of children), peritraumatic (i.e., physical and emotional reactions and dissociation), and posttraumatic factors (i.e., ASD, depression symptoms, and seeking psychological help at the employee assistance program and at the police union between the event and Time 1). Clinical implications of these findings are discussed and key directions for future studies are proposed.

  13. Family structure and posttraumatic stress reactions: a longitudinal study using multilevel analyses

    Directory of Open Access Journals (Sweden)

    Nygaard Egil

    2011-12-01

    Full Text Available Abstract Background There is limited research on the relevance of family structures to the development and maintenance of posttraumatic stress following disasters. We longitudinally studied the effects of marital and parental statuses on posttraumatic stress reactions after the 2004 Southeast Asian tsunami and whether persons in the same households had more shared stress reactions than others. Method The study included a tourist population of 641 Norwegian adult citizens, many of them from families with children. We measured posttraumatic stress symptoms with the Impact of Event Scale-Revised at 6 months and 2 years post-disaster. Analyses included multilevel methods with mixed effects models. Results Results showed that neither marital nor parental status was significantly related to posttraumatic stress. At both assessments, adults living in the same household reported levels of posttraumatic stress that were more similar to one another than adults who were not living together. Between households, disaster experiences were closely related to the variance in posttraumatic stress symptom levels at both assessments. Within households, however, disaster experiences were less related to the variance in symptom level at 2 years than at 6 months. Conclusions These results indicate that adult household members may influence one another's posttraumatic stress reactions as well as their interpretations of the disaster experiences over time. Our findings suggest that multilevel methods may provide important information about family processes after disasters.

  14. Loving-kindness meditation for posttraumatic stress disorder: a pilot study.

    Science.gov (United States)

    Kearney, David J; Malte, Carol A; McManus, Carolyn; Martinez, Michelle E; Felleman, Ben; Simpson, Tracy L

    2013-08-01

    Loving-kindness meditation is a practice designed to enhance feelings of kindness and compassion for self and others. Loving-kindness meditation involves repetition of phrases of positive intention for self and others. We undertook an open pilot trial of loving-kindness meditation for veterans with posttraumatic stress disorder (PTSD). Measures of PTSD, depression, self-compassion, and mindfulness were obtained at baseline, after a 12-week loving-kindness meditation course, and 3 months later. Effect sizes were calculated from baseline to each follow-up point, and self-compassion was assessed as a mediator. Attendance was high; 74% attended 9-12 classes. Self-compassion increased with large effect sizes and mindfulness increased with medium to large effect sizes. A large effect size was found for PTSD symptoms at 3-month follow-up (d = -0.89), and a medium effect size was found for depression at 3-month follow-up (d = -0.49). There was evidence of mediation of reductions in PTSD symptoms and depression by enhanced self-compassion. Overall, loving-kindness meditation appeared safe and acceptable and was associated with reduced symptoms of PTSD and depression. Additional study of loving-kindness meditation for PTSD is warranted to determine whether the changes seen are due to the loving-kindness meditation intervention versus other influences, including concurrent receipt of other treatments.

  15. Predictors of Youths' Posttraumatic Stress Symptoms Following a Natural Disaster: The 2010 Nashville, Tennessee, Flood.

    Science.gov (United States)

    Martin, Nina C; Felton, Julia W; Cole, David A

    2016-01-01

    Framed by a previously established conceptual model of youths' posttraumatic stress (PTS) responses following a disaster, the current longitudinal study examined the relation of predisaster child characteristics (age, gender, depressive symptoms, ruminative coping), predisaster environmental characteristics (negative life events and supportive and negative friendship interactions), and level of disaster exposure to youths' PTS symptoms in the wake of a natural disaster. Prior to the 2010 Nashville, Tennessee, flood, 239 predominantly Caucasian youth from four elementary and middle schools (ages = 10-15, 56% girls) completed measures of depressive symptoms, rumination, negative life events, and social support in the form of both supportive and negative friendship interactions. Approximately 10 days after returning to school, 125 completed measures of disaster exposure and postflood PTS symptoms. Bivariate correlations revealed that disaster-related PTS symptoms were unrelated to age, gender, or predisaster supportive friendship interactions and significantly positively related to level of disaster exposure and predisaster levels of negative life events, depressive symptoms, rumination, and negative friendship interactions. After controlling for level of disaster exposure and other predisaster child and environmental characteristics, depressive symptoms and negative friendship interactions predicted postdisaster PTS symptoms. The effect of child's flood-related experiences on PTS symptoms was not moderated by any of the preexisting child characteristics or environmental indicators. Faced with limited resources after a natural disaster, school counselors and other health professionals should focus special attention on youths who experienced high levels of disaster-related losses and whose predisaster emotional and interpersonal lives were problematic.

  16. Pediatric seizure-related posttraumatic stress and anxiety symptoms treated with EMDR: a case series

    Directory of Open Access Journals (Sweden)

    Elmedina Dautovic

    2016-07-01

    Full Text Available Purpose: To examine the potential effects of eye movement desensitization and reprocessing (EMDR in children with epilepsy-related posttraumatic stress and/or anxiety symptoms, using a case series design. Methods: Five children (aged 8–18 with epilepsy identified for seizure-related posttraumatic stress and/or anxiety symptoms were treated with EMDR. To examine potential treatment effects, posttraumatic stress and anxiety symptoms were assessed (CRTI and SCARED pre- and post-EMDR and at 3-month follow-up. Normative deviation scores were calculated to examine the severity of seizure-related posttraumatic stress and anxiety symptoms over time. The reliable change index was calculated for pre- to posttreatment change of seizure-related posttraumatic stress and/or anxiety symptoms. Results: Before EMDR, overall or subscale scores indicated that all children had (subclinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms. Directly after EMDR, most children showed significant and/or clinical individual improvement, and these beneficial effects were maintained or reached at follow-up. The mean number of sessions was 2 (range 1–3, 45 min per session. Conclusions: In case of seizure-related posttraumatic stress and/or anxiety, this study indicates that EMDR is a potentially successful quick and safe psychological treatment for children with epilepsy.

  17. Posttraumatic stress and growth in student service members and veterans: The role of personal growth initiative.

    Science.gov (United States)

    Borowa, Dominika; Robitschek, Christine; Harmon, Kevin Andrew; Shigemoto, Yuki

    2016-10-01

    This study explored the extent to which personal growth initiative (PGI) may predict posttraumatic stress and growth in student service members/veterans (SSM/V). Participants were 136 SSM/V (79% men) representing multiple branches of the armed forces. Forty-four percent of participants reported having combat experience. Data collection occurred from October 2013 to February 2014. Data were collected via a Web-based survey that included demographics and measures of personal growth initiative, posttraumatic stress, posttraumatic growth, and perceived social support. Results indicated that PGI is not a unique predictor of posttraumatic stress but is a unique predictor of higher levels of posttraumatic growth. PGI appears to be at least as important as perceived social support in facilitating growth in SSM/V. This study provides further evidence for PGI's potential to facilitate growth after a traumatic event.

  18. Pharmacological enhancement of behavioral therapy: focus on posttraumatic stress disorder.

    Science.gov (United States)

    Choi, Dennis C; Rothbaum, Barbara O; Gerardi, Maryrose; Ressler, Kerry J

    2010-01-01

    Improved efficacy in the treatment of posttraumatic stress disorder (PTSD) and other anxiety disorders is urgently needed. Traditional anxiety treatments of hypnosis and psychodynamic therapy may be of some help, but uncontrolled studies lead to inconclusive results on the efficacy of these treatment techniques. There is a larger literature supporting the efficacy of cognitive-behavioral procedures with PTSD, including prolonged exposure therapy, eye movement desensitization and reprocessing, and anxiety management techniques. The cutting-edge technology of virtual reality-based exposure therapy for PTSD is particularly exciting. To further build on effective psychosocial treatments, current pharmacological augmentation approaches to emotional learning are being combined with psychotherapy. In particular, D-cycloserine, a partial NMDA agonist, has shown to be effective in facilitating the exposure/extinction therapy to improve the efficacy of treating anxiety disorders, and may guide the way for new pharmacological enhancements of behavioral therapy.

  19. Predicting criminality from child maltreatment typologies and posttraumatic stress symptoms

    DEFF Research Database (Denmark)

    Elklit, Ask; Karstoft, Karen-Inge; Armour, Cherie

    2013-01-01

    The associations between childhood abuse and subsequent criminality and posttraumatic stress disorder (PTSD) are well known. However, a major limitation of research related to childhood abuse and its effects is the focus on one particular type of abuse at the expense of others. Recent work has...... established that childhood abuse rarely occurs as a one-dimensional phenomenon. Therefore, a number of studies have investigated the existence of abuse typologies. Methods: The study is based on a Danish stratified random probability survey including 2980 interviews of 24-year-old people. The sample...... was constructed to include an oversampling of child protection cases. Building on a previous latent class analysis of four types of childhood maltreatment, three maltreatment typologies were used in the current analyses. A criminality scale was constructed based on seven types of criminal behavior. PTSD symptoms...

  20. Post-traumatic stress disorder in children and adolescents.

    Science.gov (United States)

    Chowdhury, Uttom; Pancha, Amit

    2011-12-01

    Post-traumatic stress disorder (PTSD) is a syndrome defined by the intrusive re-experiencing of trauma, avoidance of reminders of the trauma and increased hyperarousal. Although the condition is well established in adults, there is little research into PTSD in children and adolescents. The available research shows that young people experience similar symptoms to adults. Risk factors include family dysfunction, peer problems, greater exposure to the trauma and the presence of pre-existing psychiatric disorder such as anxiety. Protective factors include good coping skills, good relationship with a parent and support from others in the community. This article reviews treatment approaches to PTSD in young people in particular the use of cognitive behavioural therapy (CBT).

  1. Predicting criminality from child maltreatment typologies and posttraumatic stress symptoms

    DEFF Research Database (Denmark)

    Elklit, Ask; Karstoft, Karen-Inge; Armour, Cherie

    2013-01-01

    The associations between childhood abuse and subsequent criminality and posttraumatic stress disorder (PTSD) are well known. However, a major limitation of research related to childhood abuse and its effects is the focus on one particular type of abuse at the expense of others. Recent work has...... established that childhood abuse rarely occurs as a one-dimensional phenomenon. Therefore, a number of studies have investigated the existence of abuse typologies. Methods: The study is based on a Danish stratified random probability survey including 2980 interviews of 24-year-old people. The sample...... was constructed to include an oversampling of child protection cases. Building on a previous latent class analysis of four types of childhood maltreatment, three maltreatment typologies were used in the current analyses. A criminality scale was constructed based on seven types of criminal behavior. PTSD symptoms...

  2. [Historical evolution of the concept of posttraumatic stress disorder].

    Science.gov (United States)

    Schestatsky, Sidnei; Shansis, Flávio; Ceitlin, Lúcia Helena; Abreu, Paulo B S; Hauck, Simone

    2003-06-01

    The authors elaborate on the historical evolution of the concept of Posttraumatic Stress Disorder (PTSD). The authors quote the French scholars, mainly Charcot and Janet, as the first to connect traumatic events and symptoms of hysteria. The contributions of Freud are described with enphasis on his effort into integrating the intra-psychic and environmental dimensions. Kardiner is referred as the author who coined the concept of 'war neurosis', which was deemed as an important one during the Second World War and Vietnam War. In conclusion, the authors highlight that the concept of PTSD used in the Diagnostic and Statistical Manual of Mental Disorders (DSM) by the American Psychiatric Association assess, at the same time, how treatening was the traumatic event and the list of symptoms presented by the patients.

  3. Is Helplessness Still Helpful in Diagnosing Posttraumatic Stress Disorder?

    Science.gov (United States)

    Pivovarova, Ekaterina; Tanaka, Gen; Tang, Michael; Bursztajn, Harold J; First, Michael B

    2016-01-01

    Criteria A2, experience of helplessness, fear, or horror at the time of the traumatic event, was removed from the posttraumatic stress disorder diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We argue that there is empirical support for retention of A2, a criterion that has clinical value and may improve diagnostic accuracy. Specifically, we demonstrate that A2 has high negative predictive power, aids in the prediction of symptom severity, and can be indispensible to detecting the disorder in children. We examine how augmenting A2 with other peritramautic emotions could improve clinical and diagnostic utility. In our opinion, rather than being eliminated, A2 needs to be reconstructed and included as one criterion of PTSD.

  4. A memory-based model of posttraumatic stress disorder

    DEFF Research Database (Denmark)

    Rubin, David C.; Berntsen, Dorthe; Johansen, Marlene Klindt

    2008-01-01

    . Predisposing factors that affect the current memory have large effects on symptoms. The inability-to-recall-an-important-aspect-of-the-trauma symptom does not correlate with other symptoms. Loss or enhancement of the trauma memory affects PTSD symptoms in predictable ways. Special mechanisms that apply only......In the mnemonic model of posttraumatic stress disorder (PTSD), the current memory of a negative event, not the event itself, determines symptoms. The model is an alternative to the current event-based etiology of PTSD represented in the Diagnostic and Statistical Manual of Mental Disorders (4th ed...... objective information about the trauma and peritraumatic emotions but uses retrospective memory reports that can have substantial biases. Negative events and emotions that do not satisfy the current diagnostic criteria for a trauma can be followed by symptoms that would otherwise qualify for PTSD...

  5. Are Posttraumatic Stress Symptoms Related to Mental Health Service Use?

    DEFF Research Database (Denmark)

    Madsen, Trine; Andersen, Søren Bo; Karstoft, Karen-Inge

    2016-01-01

    the Danish registers. RESULTS: The prevalence of PTSD symptoms increased over time, and almost 10% of the sample reported high levels of PTSD symptoms 2.5 years postdeployment. Overall, 37% of the soldiers utilized mental health services; 6% utilized psychiatric services, and 12.4% redeemed a prescription...... of posttraumatic stress disorder (PTSD) in soldiers before and after deployment to Afghanistan. METHODS: Prospectively, 703 Danish soldiers who deployed from January 2009 to August 2009 were followed up with 6 assessments from predeployment to 2.5 years postdeployment in 2012. At assessments, the soldiers...... responded to a comprehensive questionnaire including a measure of PTSD symptoms (the PTSD Checklist-Civilian version). These self-reported data were combined with individual-level records of receiving psychotherapy from the Military Psychological Division at the Danish Defense and psychiatric treatment from...

  6. POSTTRAUMATIC STRESS SYMPTOMS IN MEXICAN JOURNALISTS COVERING THE DRUG WAR

    Directory of Open Access Journals (Sweden)

    Rogelio Flores Morales

    2012-06-01

    Full Text Available The present study obtained data on the frequency of Posttraumatic Stress Disorder (PTSD symptoms from a national sample of Mexican journalists. The main objective of this exploratory and transversal study was to assess PTSD symptoms, and identify differences by gender (male/female, assignment (journalists who cover drug trafficking news/other journalists, and professional activity (reporter/photographer. The PTSD Checklist-Civilian Version (PCL-C, and a questionnaire on sociodemographic data were used. The instruments were applied in a national context of war on drugs, in which acts of extreme violence like mass murders, beheadings and skinning are present. Results indicate that 35% of the journalists had PTSD symptoms. However, rates of PTSD symptoms in reporters who cover drug war news were significantly higher than in journalists who cover other assignments (p=.03.

  7. Primary prevention of posttraumatic stress disorder:drugs and implications

    Institute of Scientific and Technical Information of China (English)

    Joachim C Burbiel

    2015-01-01

    Because posttraumatic stress disorder (PTSD) is a highly debilitating condition, prevention is an important research topic. This article reviews possible prevention approaches that involve the administration of drugs before the traumatic event takes place. The considered approaches include drugs that address the sympathetic nervous system, drugs interfere with the hypothalamic-pituitary-adrenal (HPA) axis, narcotics and other psychoactive drugs, as well as modulators of protein synthesis. Furthermore, some thoughts on potential ethical implications of the use of drugs for the primary prevention of PTDS are presented. While there are many barriers to overcome in this field of study, this paper concludes with a call for additional research, as there are currently no approaches that are well-suited for regular daily use.

  8. Management on tsunami causing posttraumatic stress disorder: a case report.

    Science.gov (United States)

    Jarusuraisin, Ngamwong; Kesornsukon, Kanch

    2005-11-01

    On December 26, 2004, tsunamis hit Southeast Asia and caused serious damage and loss of lives. In Thailand, six provinces (Ranong, Phang-Nga, Phuket, Krabi, Trang, and Satun) were impacted. The present study reports the psychiatric assessments such as Thai GHQ-60 and IES. It also reports management techniques of both cognitive behavior therapy and medication. Those were provided to a Thai female patient who was 54 years old. The patient responded to treatment quickly because of early management. The tsunami victim with Posttraumatic Stress Disorder (PTSD) is not an individual. A mass of people who faced or witnessed the tsunami are vulnerable to get PTSD any time during 6 months after trauma. These early management techniques are useful and practical for a mass of victims and survivors.

  9. [Family-centered care and post-traumatic stress disorder].

    Science.gov (United States)

    Lin, Chia-Huei; Sun, Yin-Jhen; Tzeng, Wen-Chii; Chiang, Li-Chi

    2012-06-01

    A year has passed since a major earthquake and tsunami hit northeastern Honshu, Japan in March 2011. Amidst mourning for the tens of thousands of victims, survivors have just begun the difficult and urgent tasks of rebuilding. Many survivors suffer from post-traumatic stress disorder (PTSD). PTSD causes chronic, long-term suffering for patients and their families and inevitably burdens social and medical care systems. This article tries to integrate PTSD evidence-based treatment experiences into a practical and detailed nursing intervention protocol for PTSD. We also elicit the function and effect of "family-centered care." We hope that nursing professionals apply family-centered care principles to PTSD treatment and care approaches in order to promote PTSD patient resilience. Nurses can thus enhance PTSD care efficacy and improve the opportunity for PTSD patients to overcome their symptoms and recover their life.

  10. Post-traumatic stress disorder: emerging concepts of pharmacotherapy.

    Science.gov (United States)

    Baker, Dewleen G; Nievergelt, Caroline M; Risbrough, Victoria B

    2009-06-01

    Post-traumatic stress disorder (PTSD) can result from a traumatic experience that elicits emotions of fear, helpless or horror. Most individuals remain asymptomatic or symptoms quickly resolve, but in a minority intrusive imagery and nightmares, emotional numbing and avoidance, and hyperarousal persist for decades. PTSD is associated with psychiatric and medical co-morbidities, increased risk for suicide, and with poor social and occupational functioning. Psychotherapy and pharmacotherapy are common treatments. Whereas, research supports the efficacy of the cognitive behavioral psychotherapies, there is insufficient evidence to unequivocally support the efficacy of any specific pharmacotherapy. Proven effective pharmacologic agents are sorely needed to treat core and targeted PTSD symptoms, and for prevention. This review describes current and emerging pharmacotherapies that advance these goals.

  11. Factors related to posttraumatic stress disorder in adolescence.

    Science.gov (United States)

    Nooner, Kate B; Linares, L Oriana; Batinjane, Jessica; Kramer, Rachel A; Silva, Raul; Cloitre, Marylene

    2012-07-01

    Studies of posttraumatic stress disorder (PTSD) in adolescence published from 2000 to 2011 indicate that adolescents are at greater risk of experiencing trauma than either adults or children, and that the prevalence of PTSD among adolescents is 3-57%. Age, gender, type of trauma, and repeated trauma are discussed as factors related to the increased rates of adolescent PTSD. PTSD in adolescence is also associated with suicide, substance abuse, poor social support, academic problems, and poor physical health. PTSD may disrupt biological maturational processes and contribute to the long-term emotion and behavior regulation problems that are often evident in adolescents with the disorder. Recommendations are presented for practice and research regarding the promotion of targeted prevention and intervention services to maximize adolescents' strengths and minimize vulnerabilities. Public policy implications are discussed.

  12. Symptoms of posttraumatic stress disorder among urban residents.

    Science.gov (United States)

    Parto, Jacklyn A; Evans, Michele K; Zonderman, Alan B

    2011-07-01

    Previous studies indicate a high risk of Posttraumatic Stress Disorder (PTSD) among women and low-income, urban-residing African-Americans. This study examined PTSD symptoms among urban-residing, socioeconomically diverse, working-age African-Americans and whites. The participants completed the PTSD Checklist-Civilian Version. Of the 2104 participants, 268 (12.7%) were screened positive for PTSD symptoms. Women (13.8%) were more likely than men (11.3%), white participants (13.8%) were more likely than African-Americans (11.9%), and younger participants (16.1%) were more likely than older participants (10.2%) to screen positive for PTSD symptoms. A significant interaction (p = 0.05) revealed that white women living below the 125% poverty level were most likely to report PTSD symptoms. These findings highlight the importance of PTSD screening in low-income urban neighborhoods.

  13. Biological studies of post-traumatic stress disorder.

    Science.gov (United States)

    Pitman, Roger K; Rasmusson, Ann M; Koenen, Karestan C; Shin, Lisa M; Orr, Scott P; Gilbertson, Mark W; Milad, Mohammed R; Liberzon, Israel

    2012-11-01

    Post-traumatic stress disorder (PTSD) is the only major mental disorder for which a cause is considered to be known: that is, an event that involves threat to the physical integrity of oneself or others and induces a response of intense fear, helplessness or horror. Although PTSD is still largely regarded as a psychological phenomenon, over the past three decades the growth of the biological PTSD literature has been explosive, and thousands of references now exist. Ultimately, the impact of an environmental event, such as a psychological trauma, must be understood at organic, cellular and molecular levels. This Review attempts to present the current state of this understanding on the basis of psychophysiological, structural and functional neuroimaging, and endocrinological, genetic and molecular biological studies in humans and in animal models.

  14. Be vigilant for post-traumatic stress reactions.

    Science.gov (United States)

    Hull, Alastair M; Curran, Stephen A

    2016-05-01

    Most people experience at least one potentially traumatic event (PTE) during their life. Many will develop only transient distress and not a psychological illness. Even the most inherently horrific event does not invariably lead to the development of a psychological disorder while an individual with sufficient vulnerabilit may develop post-traumatic stress disorder (PTSD) after what appears be an event of low magnitude. The diagnosis of PTSD differs fro most psychiatric disorders as it includes an aetiological factor, the traumatic event, as a core criterion. The DSM 5 core symptoms of PTSD are grouped into four key symptom clusters: re-experiencing, avoidance, negative cognitions and mood, and arousal. Symptoms must be present for at least one month and cause functional impairment. PTSD patients can avoid engaging in treatment and assertive follow-up may be necessary.

  15. Overgeneral memory extends to pictorial retrieval cues and correlates with cognitive features in posttraumatic stress disorder.

    Science.gov (United States)

    Schönfeld, Sabine; Ehlers, Anke

    2006-11-01

    Individuals with posttraumatic stress disorder (PTSD) show overgeneral memory (OGM) when retrieving autobiographical memories to word cues. We investigated whether OGM extends to picture cues and whether it is related to PTSD symptoms and cognitions. Trauma survivors with (n = 29) and without (n = 26) PTSD completed the standard Autobiographical Memory Test (AMT) and a novel picture version. Compared to the no-PTSD group, the PTSD group showed OGM in both test versions. Pictures facilitated specific memory retrieval, but this effect was no longer significant when verbal intelligence or depressive symptoms were controlled. OGM correlated with PTSD symptoms and perceived self-change; with intrusive memories, their perceived "nowness," responses to intrusions (thought suppression, rumination, dissociation), and negative interpretations of symptoms.

  16. A pharmacotherapeutic approach to the management of chronic posttraumatic stress disorder.

    Science.gov (United States)

    Spaulding, Adam Michael

    2012-10-01

    Due to relatively recent and ongoing world events (eg, terrorist attacks, wars, and natural disasters), there has been a shift in attention from some of the more common psychiatric illnesses to one of the more elusive, namely, posttraumatic stress disorder (PTSD). PTSD is a severe, and often chronic, condition that can lead to significant morbidity and mortality. Although originally a condition seen primarily among war veterans, PTSD is now becoming more prevalent in the general community. PTSD often presents concurrently with other conditions, such as depression, bipolar, anxiety/panic disorders, and alcohol and drug abuse. Because of this, PTSD often goes unrecognized and is underdiagnosed in clinical practice. Thus, an opportunity for pharmacist intervention exists, both in the institution and in the community. With proper education and training, pharmacists can be efficient in screening for signs and symptoms of PTSD, triaging appropriate patients, and can play an integral role in managing the diverse array of drug therapy options for PTSD.

  17. Posttraumatic stress disorder: protective and risk factors in 18 survivors of a plane crash.

    Science.gov (United States)

    Catanesi, Roberto; Martino, Vito; Candelli, Chiara; Troccoli, Giuseppe; Grattagliano, Ignazio; Di Vella, Giancarlo; Carabellese, Felice

    2013-09-01

    The aim of this study is to identify protective and risk factors related to the development of posttraumatic stress disorder (PTSD) on a sample of survivors from a single plane crash. Eighteen survivors were examined 6 months following the event. The subjects all underwent psychiatric interviews, Clinician-Administered PTSD Scale structured interviews, personality and cognitive tests. Only 38.9% of them presented with all of the symptoms of PTSD; 22.2% showed no symptoms for PTSD; remaining survivors exhibited emotional/affective symptoms related to the event. In addition to the severity of the traumatic event itself, other risk factors identified were the loss of a relative, the manifestation of depressive symptoms, and the severity of physical injuries sustained. Low levels of hostility and high levels of self-efficacy represented protective factors against developing PTSD.

  18. A test of written emotional disclosure as an intervention for posttraumatic stress disorder.

    Science.gov (United States)

    Sloan, Denise M; Marx, Brian P; Greenberg, Eva M

    2011-04-01

    This study examined the efficacy of the written emotional disclosure (WED) procedure with a sample of young adults who met diagnostic criteria for posttraumatic stress disorder (PTSD). Participants were randomly assigned to either WED or a control writing condition and were assessed at baseline and one month following the writing sessions. During each writing session, participants' heart rate was recorded; participants also provided self-report ratings of emotional responding. Findings indicated no significant group differences for PTSD and depression symptom severity at follow-up assessment. Relative to control participants, WED participants displayed significantly greater heart rate activity and reported greater emotional responding during the first writing session; however, no reduction in emotional responding occurred for either condition from the first to the last writing session. Taken together, these findings indicate that WED may not be an efficacious intervention for PTSD. Suggestions are made for future work in this area.

  19. Mechanisms Underlying Footshock and Psychological Stress-Induced Abrupt Awakening From Posttraumatic “Nightmares”

    OpenAIRE

    Yu, Bin; Cui, Su-ying; Zhang, Xue-Qiong; Cui, Xiang-yu; Li, Sheng-jie; Sheng, Zhao-fu; Cao, Qing; Huang, Yuan-Li; Xu, Ya-Ping; Lin, Zhi-Ge; Yang, Guang; Song, Jin-Zhi; Ding, Hui; Zhang, Yong-He

    2015-01-01

    Background: Posttraumatic nightmares are a highly prevalent and distressing symptom of posttraumatic stress disorder (PTSD), but have been the subject of limited phenomenological investigations. Methods: We utilized a communication box to establish PTSD symptoms in rats through exposure to footshock stress (FS) and psychological stress (PS). The immunohistochemical test and high-performance liquid chromatography with electrochemical detection were used to detect the activity and monoamine lev...

  20. Tips to Manage Anxiety and Stress

    Science.gov (United States)

    ... Disorder Specific Phobias Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) Depression Bipolar Disorder Suicide and Prevention Stress Related Illnesses Myth-Conceptions Find ...

  1. Posttraumatic stress disorder in bosnian war veterans: Analysis of stress events and risk factors

    Directory of Open Access Journals (Sweden)

    Kuljić Blagoje

    2004-01-01

    Full Text Available The aim of this study was to determine the incidence of Post-Traumatic Stress Disorder (PTSD, the characteristics of stress-related events, and the risk factors for the development of PTSD. The total patient sample consisted of 100 Bosnian war veterans. Watson’s PTSD module was used in establishing PTSD diagnosis. Patients fulfilled the following questionnaires: personal data form, Posttraumatic Symptom Scale PTSS-10 (Holen, Impact of Event Scale (Horowitz, Life Event Scale, and Eysenck Personality Inventory. PTSD was diagnosed in 30% of the examined patients. Larger number of stress-related events, particularly of those regarded as life-threatening, wounding/death of a close person, and material losses were more frequent in persons with PTSD. The risk factors for the development of PTSD in this study were: age (30-40, marital status (married, lower level of education, the front-line combat exposure, neurotic manifestations, family problems in childhood, and neuroticism.

  2. Posttraumatic stress disorder in early childhood: classification and diagnostic issues

    Directory of Open Access Journals (Sweden)

    Alessandra Simonelli

    2013-12-01

    Full Text Available The 0–3 diagnostic classification of infant mental health, on the basis of DSM-IV-R, describes posttraumatic stress disorder (PTSD as a pattern of symptoms that may be shown by children who have experienced a single traumatic event, a series of connected traumatic events, or chronic, enduring stress situations. This definition, related to young children, needs the consideration of several factors to understand the child's symptoms, organize the diagnostic process, and realize clinical interventions. In this sense, the clinician must appreciate the classification criteria of PTSD in early childhood in the context of the child's age, temperament, and developmental level. This report presents a review of the research in the domain of the PTSD in early childhood with particular attention to the developmental considerations to define critical diagnostic criteria, specifically organized on the child characteristics, competences, and needs. Along this line, it will describe two proposed modifications of the diagnostic classification in childhood: the Post Traumatic Stress Disorder Alternative Algorithm (PTSD-AA and the definition of developmental trauma disorder (DTD.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  3. Effect of elective surgery on subjective health in veterans with chronic posttraumatic stress disorder.

    Science.gov (United States)

    Wofford, Ken; Hertzberg, Michael; Silva, Susan; Vacchiano, Charles

    2014-08-01

    Posttraumatic stress disorder (PTSD) is common, is often chronic, and has been associated with greater risk of postoperative mortality in veterans. The purpose of this study was to determine if elective outpatient surgery had a persistent effect on the physical or mental health of veterans with chronic PTSD. A longitudinal, quasi-experimental study was conducted that followed up 60 veterans with chronic PTSD over 12 weeks. Self-reported physical and mental health, depressive symptom severity, and posttraumatic symptom severity were measured in 29 veterans undergoing outpatient elective surgery and 31 veterans not having elective surgery (controls). Data collection was performed at baseline and repeated 1, 4, and 12 weeks after surgery or enrollment. At baseline, both surgical and control subjects reported poor physical and mental subjective health status. After surgery, surgical group subjects reported mean age- and gender-adjusted reductions of 3.9 points on the Physical Component Summary score and 2.9 points on the Mental Component Summary score of the Veterans Rand 36-item Health Survey, which resolved by 4 weeks after surgery. These findings suggest that veterans with PTSD were at greater risk of mortality because of poor baseline health, but did not demonstrate persistent decline in health following common elective surgical procedures.

  4. Childhood antecedents of exposure to traumatic events and posttraumatic stress disorder.

    Science.gov (United States)

    Storr, Carla L; Ialongo, Nicholas S; Anthony, James C; Breslau, Naomi

    2007-01-01

    The authors prospectively examined childhood antecedents of exposure to traumatic events to estimate the risk of posttraumatic stress disorder (PTSD) among those exposed to trauma. Two consecutive cohorts of children entering first grade of a public school system in a large mid-Atlantic city in the mid-1980s were followed into young adulthood (mean age=21). Exposure to traumatic events and PTSD were assessed in 75% of the original cohort (N=1,698). Childhood assessments, conducted upon entry into the first grade, included standardized measures of reading readiness, teacher ratings of behavioral problems, and child self-reports about depression and anxiety. Family characteristics were assessed by parental report. Young adults who had been rated by their first grade teacher as having aggressive/disruptive behavior problems were more likely to experience traumatic assaultive violence events (e.g., being mugged/threatened with a weapon, badly beaten-up) (relative risk=2.6) but not PTSD following trauma exposure. Youths with high levels of self-rated depressive and anxious feelings in first grade were more likely to experience PTSD once exposed to trauma (relative risk=1.5). Youths who scored in the highest quartile on a reading test in the first grade were at lower risk for exposure to assaultive violence traumas. Childhood behavioral and depressive/anxious problems may influence the risk for PTSD directly by increasing the vulnerability to the PTSD effects of trauma exposure, and indirectly by increasing the likelihood of exposure to assaultive violence.

  5. Post-traumatic stress disorder and suicidal behavior: A narrative review.

    Science.gov (United States)

    Panagioti, Maria; Gooding, Patricia; Tarrier, Nicholas

    2009-08-01

    There is a large literature investigating the underlying mechanisms, risk factors and demographics of suicidal thoughts and behaviors across a number of psychiatric disorders, such as, major depression, anxiety and schizophrenia. However, less research has focused on the relationship between Post-Traumatic Stress Disorder (PTSD) and suicide. There were two broad aims of this review. The first was to assess the extent to which PTSD is associated with suicide, and the second was to determine the effects of co-morbid disorders on this relationship. Overall, there was a clear relationship between PTSD and suicidal thoughts and behaviors irrespective of the type of trauma experienced. Very few studies directly examined whether depression was a mediating factor in the relationships reported. However, where this was investigated, the presence of co-morbid depression appeared to boost the effect of PTSD on suicidality. It was noteworthy that hardly any studies had investigated concepts thought to be key in other domains of research into suicidality, such as, feelings of entrapment, defeat and hopelessness.

  6. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-01-01

    Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the stro...

  7. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Milgrom Jeannette; Leigh Bronwyn

    2008-01-01

    Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite...

  8. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Milgrom Jeannette; Leigh Bronwyn

    2008-01-01

    Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite...

  9. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-01-01

    Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the stro...

  10. Disrupted rapid eye movement sleep predicts poor declarative memory performance in post-traumatic stress disorder.

    Science.gov (United States)

    Lipinska, Malgorzata; Timol, Ridwana; Kaminer, Debra; Thomas, Kevin G F

    2014-06-01

    Successful memory consolidation during sleep depends on healthy slow-wave and rapid eye movement sleep, and on successful transition across sleep stages. In post-traumatic stress disorder, sleep is disrupted and memory is impaired, but relations between these two variables in the psychiatric condition remain unexplored. We examined whether disrupted sleep, and consequent disrupted memory consolidation, is a mechanism underlying declarative memory deficits in post-traumatic stress disorder. We recruited three matched groups of participants: post-traumatic stress disorder (n = 16); trauma-exposed non-post-traumatic stress disorder (n = 15); and healthy control (n = 14). They completed memory tasks before and after 8 h of sleep. We measured sleep variables using sleep-adapted electroencephalography. Post-traumatic stress disorder-diagnosed participants experienced significantly less sleep efficiency and rapid eye movement sleep percentage, and experienced more awakenings and wake percentage in the second half of the night than did participants in the other two groups. After sleep, post-traumatic stress disorder-diagnosed participants retained significantly less information on a declarative memory task than controls. Rapid eye movement percentage, wake percentage and sleep efficiency correlated with retention of information over the night. Furthermore, lower rapid eye movement percentage predicted poorer retention in post-traumatic stress disorder-diagnosed individuals. Our results suggest that declarative memory consolidation is disrupted during sleep in post-traumatic stress disorder. These data are consistent with theories suggesting that sleep benefits memory consolidation via predictable neurobiological mechanisms, and that rapid eye movement disruption is more than a symptom of post-traumatic stress disorder.

  11. Stress and Depression among Veterinary Medical Students.

    Science.gov (United States)

    Killinger, Stacy L; Flanagan, Sean; Castine, Eleanor; Howard, Kimberly A S

    While existing literature suggests that professional students (e.g., medical, dental, law, nursing, etc.) experience high levels of stress and depression, the experiences of veterinary medical students have been less well examined. The purpose of this study was to explore the levels of stress and depression among veterinary medical students and to examine the relationship between these variables. Study participants were 1,245 veterinary medical students from North America. The findings provide support for the assertion that veterinary medical students experience high levels of stress and depression. Results also indicated that there is a correlation between stress and depression for veterinary medical students and that female students experience higher levels of stress and depression than their male counterparts.

  12. Relationships between mobbing at work and MMPI-2 personality profile, posttraumatic stress symptoms, and suicidal ideation and behavior.

    Science.gov (United States)

    Balducci, Cristian; Alfano, Vincenzo; Fraccaroli, Franco

    2009-01-01

    This study investigates the relationships between the experience of mobbing at work and personality traits and symptom patterns as assessed by means of the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2). Participants were 107 workers who had contacted mental health services because they perceived themselves as victims of mobbing. In line with previous research, the results showed that the MMPI-2 mean profile was characterized by a neurotic component as evidenced by elevations of Scales 1, 2, and 3 and a paranoid component as indicated by elevation of Scale 6. Contrary to previous research, a pattern of positive and significant correlations was found between the frequency of exposure to mobbing behaviors and the MMPI-2 clinical, supplementary, and content scales, including the posttraumatic stress scale. Only about half the participants showed a severity of posttraumatic stress symptoms indicative of a posttraumatic stress disorder. The frequency of exposure to mobbing predicted suicidal ideation and behavior, with depression only partially mediating this relationship.

  13. Symptoms Associated with Vestibular Impairment in Veterans with Posttraumatic Stress Disorder

    National Research Council Canada - National Science Library

    Haber, Yaa O; Chandler, Helena K; Serrador, Jorge M

    2016-01-01

      Posttraumatic stress disorder (PTSD) is a chronic and disabling, anxiety disorder resulting from exposure to life threatening events such as a serious accident, abuse or combat (DSM IV definition...

  14. Parental response to child injury: examination of parental posttraumatic stress symptom trajectories following child accidental injury

    National Research Council Canada - National Science Library

    Le Brocque, Robyne M; Hendrikz, Joan; Kenardy, Justin A

    2010-01-01

    Trajectory analyses were used to empirically differentiate patterns of posttraumatic stress symptoms in parents following child accidental injury and explore the relationship between parent and child recovery patterns. Parent (n = 189...

  15. Posttraumatic Stress Disorder Following Preeclampsia and PPROM : A Prospective Study With 15 Months Follow-Up

    NARCIS (Netherlands)

    Stramrood, C.A.; Wessel, I.; Doornbos, B.; Aarnoudse, J.G.; van den Berg, P.P.; Weijmar Schultz, W.C.; van Pampus, M.G.

    2011-01-01

    Objective: A prospective longitudinal evaluation of the prevalence of and risk factors for posttraumatic stress disorder (PTSD) in women with preeclampsia (PE) or preterm premature rupture of membranes (PPROM) compared to uncomplicated pregnancies. Methods: Participating women completed PTSD and dep

  16. Relationship between posttraumatic stress disorder symptoms and the course of whiplash complaints

    NARCIS (Netherlands)

    Buitenhuis, Jan; de Jong, Peter J.; Jaspers, Jan P.C.; Groothoff, Johan W.

    2006-01-01

    Objective: This study investigates the relationship between posttraumatic stress disorder (PTSD) symptoms (avoidance, reexperiencing, and hyperarousal) and the presence, severity, and duration of neck complaints after motor vehicle accidents. Methods: Individuals who had been involved in traffic acc

  17. Treatment for posttraumatic stress disorder in military and veteran populations: initial assessment

    National Research Council Canada - National Science Library

    Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress Disorder; Institute of Medicine

    2012-01-01

    .... However, the signature injuries sustained by United States military personnel in these most recent conflicts are blast wounds and the psychiatric consequences to combat, particularly posttraumatic stress disorder (PTSD...

  18. Sleep disturbances and post-traumatic stress disorder; a perpetual circle?

    NARCIS (Netherlands)

    van Liempt, S.

    2012-01-01

    Background: Sleep facilitates the consolidation of fear extinction memory. Disrupted sleep has been proposed as a vulnerability factor for the development of posttraumatic stress disorder (PTSD). Moreover, nightmares and insomnia are hallmark symptoms of PTSD, possibly interfering with fear extincti

  19. Relationship between posttraumatic stress disorder symptoms and the course of whiplash complaints

    NARCIS (Netherlands)

    Buitenhuis, Jan; de Jong, Peter J.; Jaspers, Jan P.C.; Groothoff, Johan W.

    2006-01-01

    Objective: This study investigates the relationship between posttraumatic stress disorder (PTSD) symptoms (avoidance, reexperiencing, and hyperarousal) and the presence, severity, and duration of neck complaints after motor vehicle accidents. Methods: Individuals who had been involved in traffic

  20. Post-traumatic stress disorder and opioid use disorder: A narrative review of conceptual models.

    Science.gov (United States)

    Danovitch, Itai

    2016-01-01

    Post-traumatic stress disorder is highly prevalent among individuals who suffer from opioid use disorder. Compared to individuals with opioid use disorder alone, those with post-traumatic stress disorder have a worse course of illness, occupational functioning, and physical health. The neurobiological pathways underlying each disorder overlap substantially, and there are multiple pathways through which these disorders may interact. This narrative review explores evidence underpinning 3 explanatory perspectives on comorbid post-traumatic stress disorder and opioid use disorder: The opioid susceptibility model (a.k.a.: the Self-Medication Hypothesis), the post-traumatic stress disorder susceptibility model, and the common factors model. Diagnostic implications, treatment implications, and directions for future research are discussed.

  1. Cancer-Related Post-traumatic Stress (PDQ®)—Patient Version

    Science.gov (United States)

    Expert-reviewed information summary about post-traumatic stress and related symptoms in cancer patients, cancer survivors, and their family members. Assessment and treatment of these symptoms are discussed.

  2. Cancer-Related Post-traumatic Stress (PDQ®)—Health Professional Version

    Science.gov (United States)

    Expert-reviewed information summary about post-traumatic stress and related symptoms in cancer patients, cancer survivors, and their family members. Assessment and treatment of these symptoms are discussed.

  3. Preliminary Evidence of Increased Hippocampal Myelin Content in Veterans with Posttraumatic Stress Disorder.

    Science.gov (United States)

    Chao, Linda L; Tosun, Duygu; Woodward, Steven H; Kaufer, Daniela; Neylan, Thomas C

    2015-01-01

    Recent findings suggest the formation of myelin in the central nervous system by oligodendrocytes is a continuous process that can be modified with experience. For example, a recent study showed that immobilization stress increased oligodendrogensis in the dentate gyrus of adult rat hippocampus. Because changes in myelination represents an adaptive form of brain plasticity that has a greater reach in the adult brain than other forms of plasticity (e.g., neurogenesis), the objective of this "proof of concept" study was to examine whether there are differences in myelination in the hippocampi of humans with and without post-traumatic stress disorder (PTSD). We used the ratio of T1-weighted/T2-weighted magnetic resonance image (MRI) intensity to estimate the degree of hippocampal myelination in 19 male veterans with PTSD and 19 matched trauma-exposed male veterans without PTSD (mean age: 43 ± 12 years). We found that veterans with PTSD had significantly more hippocampal myelin than trauma-exposed controls. There was also found a positive correlation between estimates of hippocampal myelination and PTSD and depressive symptom severity. To our knowledge, this is the first study to examine hippocampal myelination in humans with PTSD. These results provide preliminary evidence for stress-induced hippocampal myelin formation as a potential mechanism underlying the brain abnormalities associated with vulnerability to stress.

  4. Abnormal Fear Memory as a Model for Posttraumatic Stress Disorder.

    Science.gov (United States)

    Desmedt, Aline; Marighetto, Aline; Piazza, Pier-Vincenzo

    2015-09-01

    For over a century, clinicians have consistently described the paradoxical co-existence in posttraumatic stress disorder (PTSD) of sensory intrusive hypermnesia and declarative amnesia for the same traumatic event. Although this amnesia is considered as a critical etiological factor of the development and/or persistence of PTSD, most current animal models in basic neuroscience have focused exclusively on the hypermnesia, i.e., the persistence of a strong fear memory, neglecting the qualitative alteration of fear memory. The latest is characterized by an underrepresentation of the trauma in the context-based declarative memory system in favor of its overrepresentation in a cue-based sensory/emotional memory system. Combining psychological and neurobiological data as well as theoretical hypotheses, this review supports the idea that contextual amnesia is at the core of PTSD and its persistence and that altered hippocampal-amygdalar interaction may contribute to such pathologic memory. In a first attempt to unveil the neurobiological alterations underlying PTSD-related hypermnesia/amnesia, we describe a recent animal model mimicking in mice some critical aspects of such abnormal fear memory. Finally, this line of argument emphasizes the pressing need for a systematic comparison between normal/adaptive versus abnormal/maladaptive fear memory to identify biomarkers of PTSD while distinguishing them from general stress-related, potentially adaptive, neurobiological alterations.

  5. Growth Following Adversity: Positive Psychological Perspectives on Posttraumatic Stress

    Directory of Open Access Journals (Sweden)

    Stephen Joseph

    2009-12-01

    Full Text Available The impact of traumatic events is well documented within the clinical psychology literature where it is recognized that people who experience traumatic events may go on to develop posttraumatic stress disorder (PTSD. At first glance one might ask what the relevance of positive psychology is to the study of trauma. But a number of literatures and philosophies throughout human history have conveyed the idea that there is personal gain to be found in suffering. The observation that stressful and traumatic events can provoke positive psychological changes is also contained in the major religions of Buddhism, Christianity, Hinduism, Islam, and Judaism. Within existential philosophy and humanistic psychology it has also been recognized that positive changes can come about as a result of suffering. But it is only within the last decade that the topic of growth following adversity has become a focus for empirical work. In this paper I will provide an overview of the subject and the research we have conducted at the Centre for Trauma, Resilience, and Growth (CTRG.

  6. Pediatric seizure-related posttraumatic stress and anxiety symptoms treated with EMDR: a case series

    Science.gov (United States)

    Dautovic, Elmedina; de Roos, Carlijn; van Rood, Yanda; Dommerholt, Agnes; Rodenburg, Roos

    2016-01-01

    Purpose To examine the potential effects of eye movement desensitization and reprocessing (EMDR) in children with epilepsy-related posttraumatic stress and/or anxiety symptoms, using a case series design. Methods Five children (aged 8–18) with epilepsy identified for seizure-related posttraumatic stress and/or anxiety symptoms were treated with EMDR. To examine potential treatment effects, posttraumatic stress and anxiety symptoms were assessed (CRTI and SCARED) pre- and post-EMDR and at 3-month follow-up. Normative deviation scores were calculated to examine the severity of seizure-related posttraumatic stress and anxiety symptoms over time. The reliable change index was calculated for pre- to posttreatment change of seizure-related posttraumatic stress and/or anxiety symptoms. Results Before EMDR, overall or subscale scores indicated that all children had (sub)clinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms. Directly after EMDR, most children showed significant and/or clinical individual improvement, and these beneficial effects were maintained or reached at follow-up. The mean number of sessions was 2 (range 1–3, 45 min per session). Conclusions In case of seizure-related posttraumatic stress and/or anxiety, this study indicates that EMDR is a potentially successful quick and safe psychological treatment for children with epilepsy. Highlights of the article The first study to examine the potential effects of EMDR to reduce clinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms in children with epilepsy. After 1–3 EMDR (45 min) sessions, positive treatment effects were found on a range of seizure-related PTSD symptoms and/or anxiety symptoms. During treatment, no seizures, absences, or any other adverse events were observed; the seizure diaries showed that none of the children experienced more seizures (or an unusual pattern) after treatment. At the reevaluation of EMDR, all children and parents

  7. Irrational beliefs in posttraumatic stress responses: A Rational Emotive Behaviour Therapy approach

    OpenAIRE

    Hyland, Philip; Shevlin, Mark; Adamson, Gary; Boduszek, Daniel

    2015-01-01

    The current study aimed to test a key theoretical prediction of Rational Emotive Behaviour Therapy theory by assessing the role of general and trauma-specific irrational beliefs in the prediction of posttraumatic stress responses. A sample (N = 313) of trauma-exposed emergency service workers participated in the study. Structural equation modelling results demonstrated that an REBT-based model provided satisfactory model fit and explained 89% of variance in posttraumatic stress symptomology. ...

  8. Posttraumatic stress disorder and community collective efficacy following the 2004 Florida hurricanes.

    Directory of Open Access Journals (Sweden)

    Robert J Ursano

    Full Text Available There is a paucity of research investigating the relationship of community-level characteristics such as collective efficacy and posttraumatic stress following disasters. We examine the association of collective efficacy with probable posttraumatic stress disorder and posttraumatic stress disorder symptom severity in Florida public health workers (n = 2249 exposed to the 2004 hurricane season using a multilevel approach. Anonymous questionnaires were distributed electronically to all Florida Department of Health personnel nine months after the 2004 hurricane season. The collected data were used to assess posttraumatic stress disorder and collective efficacy measured at both the individual and zip code levels. The majority of participants were female (80.42%, and ages ranged from 20 to 78 years (median = 49 years; 73.91% were European American, 13.25% were African American, and 8.65% were Hispanic. Using multi-level analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with a lower likelihood of having posttraumatic stress disorder (OR = 0.93, CI = 0.88-0.98; and OR = 0.94, CI = 0.92-0.97, respectively, even after adjusting for individual sociodemographic variables, community socioeconomic characteristic variables, individual injury/damage, and community storm damage. Higher levels of community-level collective efficacy and individual-level collective efficacy were also associated with significantly lower posttraumatic stress disorder symptom severity (b = -0.22, p<0.01; and b = -0.17, p<0.01, respectively, after adjusting for the same covariates. Lower rates of posttraumatic stress disorder are associated with communities with higher collective efficacy. Programs enhancing community collective efficacy may be an important part of prevention practices and possibly lead to a reduction in the rate of posttraumatic stress disorder post-disaster.

  9. Reduction of prefrontal thickness in military police officers with post-traumatic stress disorder

    OpenAIRE

    Baldaçara,Leonardo; Araújo, Célia; Assunção,Idaiane; Silva,Ivaldo da; Jackowski, Andrea Parolin [UNIFESP

    2017-01-01

    Abstract Background Brain-imaging studies in post-traumatic stress disorder (PTSD) have consistently revealed alterations in brain structure and function and this is correlated to symptomatology. However, few studies have investigated the role of biomarkers in PTSD some specific groups, as police officers. Objective To evaluate prefrontal and limbic volumes, and cortical thickness of police officers exposed to trauma during work who developed post-traumatic stress disorder, resilient matc...

  10. Posttraumatic stress disorder and community collective efficacy following the 2004 Florida hurricanes.

    Science.gov (United States)

    Ursano, Robert J; McKibben, Jodi B A; Reissman, Dori B; Liu, Xian; Wang, Leming; Sampson, Robert J; Fullerton, Carol S

    2014-01-01

    There is a paucity of research investigating the relationship of community-level characteristics such as collective efficacy and posttraumatic stress following disasters. We examine the association of collective efficacy with probable posttraumatic stress disorder and posttraumatic stress disorder symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Anonymous questionnaires were distributed electronically to all Florida Department of Health personnel nine months after the 2004 hurricane season. The collected data were used to assess posttraumatic stress disorder and collective efficacy measured at both the individual and zip code levels. The majority of participants were female (80.42%), and ages ranged from 20 to 78 years (median = 49 years); 73.91% were European American, 13.25% were African American, and 8.65% were Hispanic. Using multi-level analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with a lower likelihood of having posttraumatic stress disorder (OR = 0.93, CI = 0.88-0.98; and OR = 0.94, CI = 0.92-0.97, respectively), even after adjusting for individual sociodemographic variables, community socioeconomic characteristic variables, individual injury/damage, and community storm damage. Higher levels of community-level collective efficacy and individual-level collective efficacy were also associated with significantly lower posttraumatic stress disorder symptom severity (b = -0.22, p<0.01; and b = -0.17, p<0.01, respectively), after adjusting for the same covariates. Lower rates of posttraumatic stress disorder are associated with communities with higher collective efficacy. Programs enhancing community collective efficacy may be an important part of prevention practices and possibly lead to a reduction in the rate of posttraumatic stress disorder post-disaster.

  11. Irrational beliefs in posttraumatic stress responses: A Rational Emotive Behaviour Therapy approach

    OpenAIRE

    Hyland, Philip; Shevlin, Mark; Adamson, Gary; Boduszek, Daniel

    2015-01-01

    The current study aimed to test a key theoretical prediction of Rational Emotive Behaviour Therapy theory by assessing the role of general and trauma-specific irrational beliefs in the prediction of posttraumatic stress responses. A sample (N = 313) of trauma-exposed emergency service workers participated in the study. Structural equation modelling results demonstrated that an REBT-based model provided satisfactory model fit and explained 89% of variance in posttraumatic stress symptomology. ...

  12. Charles Dickens' A Tale of Two Cities: a case report of posttraumatic stress disorder.

    Science.gov (United States)

    Huber, Thomas J; te Wildt, Bert T

    2005-01-01

    In posttraumatic stress disorder, a traumatic event is persistently re-experienced in the form of intrusive recollections, dreams or dissociative flashback episodes; cues to the event lead to distress and are avoided, and there are persistent symptoms of increased arousal. While this diagnostic concept has been widely discussed and its existence questioned, a novel written by Charles Dickens long before it was included in any diagnostic system can be viewed as an early case report of posttraumatic stress disorder.

  13. Tsunami-affected Scandinavian tourists: disaster exposure and post-traumatic stress symptoms

    DEFF Research Database (Denmark)

    Heir, Trond; Rosendal, Susanne; Bergh-Johannesson, Kerstin

    2011-01-01

    Studies of short- and long-term mental effects of natural disasters have reported a high prevalence of post-traumatic stress. Less is known about disaster-exposed tourists repatriated to stable societies.......Studies of short- and long-term mental effects of natural disasters have reported a high prevalence of post-traumatic stress. Less is known about disaster-exposed tourists repatriated to stable societies....

  14. Prolonged exposure therapy for combat- and terror-related posttraumatic stress disorder: a randomized control comparison with treatment as usual.

    Science.gov (United States)

    Nacasch, Nitzah; Foa, Edna B; Huppert, Jonathan D; Tzur, Dana; Fostick, Leah; Dinstein, Yula; Polliack, Michael; Zohar, Joseph

    2011-09-01

    Empirically based studies have demonstrated that prolonged exposure therapy effectively reduces posttraumatic stress disorder (PTSD) symptoms in a vast range of traumas, yet reports of the efficacy of such therapies in combat- and terror-related PTSD are scarce. In this article, we examine the efficacy of prolonged exposure therapy in combat- and terror-related PTSD in comparison to treatment as usual (TAU). Between July 2002 and October 2005, 30 patients of a trauma unit within a psychiatric outpatient clinic were recruited and randomized into prolonged exposure versus TAU therapies. Patients were diagnosed with chronic PTSD (Mini-International Neuropsychiatric Interview criteria) related to combat- (n = 19) or terror-related (n = 11) trauma. Main outcome measures included symptoms of PTSD and depression, as measured by the PTSD Symptom Scale-Interview Version and the Beck Depression Inventory. Posttraumatic stress disorder symptom severity was significantly lower in patients who received prolonged exposure therapy in comparison to patients who received TAU (F(1,24) = 35.3, P terror-related PTSD symptoms. In addition, prolonged exposure was superior to TAU in the short- and long-term reduction of PTSD and depression symptoms. clinicaltrials.gov Identifier: NCT00229372. © Copyright 2011 Physicians Postgraduate Press, Inc.

  15. Trauma Type and Posttraumatic Stress Disorder as Predictors of Parenting Stress in Trauma-Exposed Mothers.

    Science.gov (United States)

    Wilson, Christina K; Padrón, Elena; Samuelson, Kristin W

    2017-02-01

    Trauma exposure is associated with various parenting difficulties, but few studies have examined relationships between trauma, posttraumatic stress disorder (PTSD), and parenting stress. Parenting stress is an important facet of parenting and mediates the relationship between parental trauma exposure and negative child outcomes (Owen, Thompson, & Kaslow, 2006). We examined trauma type (child maltreatment, intimate partner violence, community violence, and non-interpersonal traumas) and PTSD symptoms as predictors of parenting stress in a sample of 52 trauma-exposed mothers. Community violence exposure and PTSD symptom severity accounted for significant variance in parenting stress. Further analyses revealed that emotional numbing was the only PTSD symptom cluster accounting for variance in parenting stress scores. Results highlight the importance of addressing community violence exposure and emotion regulation difficulties with trauma-exposed mothers.

  16. Candidate hippocampal biomarkers of susceptibility and resilience to stress in a rat model of depression

    DEFF Research Database (Denmark)

    Henningsen, Kim; Palmfeldt, Johan; Christiansen, Sofie

    2012-01-01

    Susceptibility to stress plays a crucial role in the development of psychiatric disorders such as unipolar depression and post-traumatic stress disorder. In the present study the chronic mild stress rat model of depression was used to reveal stress-susceptible and stress-resilient rats. Large......-scale proteomics was used to map hippocampal protein alterations in different stress states. Membrane proteins were successfully captured by two-phase separation and peptide based proteomics. Using iTRAQ labeling coupled with mass spectrometry, more than 2000 proteins were quantified and 73 proteins were found...... to be differentially expressed. Stress susceptibility was associated with increased expression of a sodium-channel protein (SCN9A) currently investigated as a potential antidepressant target. Differential protein profiling also indicated stress susceptibility to be associated with deficits in synaptic vesicle release...

  17. CONSIDERATIONS ON DEPRESSION AND STRESS KINETOPROPHILAXY

    Directory of Open Access Journals (Sweden)

    Veronica Dan

    2011-12-01

    Full Text Available All sports activities induce a state of psychological well-being, reduce anxiety, depression and psychosocial stress.Purpose. We set investigation level of depression, energy and stress compared to a lot of male fitness practitioners from the non-practicing. Materials and methods. Research was conducted on 20 male subjects, 10 fitness practitioners and 10 sedentary who have completed 20 questionnaires containing 12 items each for three scales (depression, stress and energy, adapted to the two categories.Results. Exercicers have a lower level of depression, perceive themselves as less stressed and feel more energetic compared with nonathletes. Conclusions. The results suggest the possibility possibility of kinetic prophylaxis of depression, due to induction of testosterone secretion through exercise, hormone endowed with antidepressant effect.

  18. Religious coping, posttraumatic stress, psychological distress, and posttraumatic growth among female survivors four years after Hurricane Katrina.

    Science.gov (United States)

    Chan, Christian S; Rhodes, Jean E

    2013-04-01

    Positive and negative religious coping strategies and their relation with posttraumatic stress (PTS), psychological distress, and posttraumatic growth (PTG) were examined in the context of Hurricane Katrina. Positive religious coping was hypothesized to be associated with PTG, whereas negative religious coping was hypothesized to be associated with PTS and psychological distress. Low-income mothers (N = 386, mean age = 25.4 years, SD = 4.43) were surveyed before, and 1 and 4 years after the storm. Results from structural regression modeling indicated that negative religious coping was associated with psychological distress, but not PTS. Positive religious coping was associated with PTG. Further analysis indicated significant indirect effects of pre- and postdisaster religiousness on postdisaster PTG through positive religious coping. Findings underscore the positive and negative effect of religious variables in the context of a natural disaster. Copyright © 2013 International Society for Traumatic Stress Studies.

  19. Client-centred therapy, post-traumatic stress disorder and post-traumatic growth: theoretical perspectives and practical implications.

    Science.gov (United States)

    Joseph, Stephen

    2004-03-01

    In practice it is not unusual for client-centred therapists to work with people who have experienced traumatic events. However, client-centred therapy is not usually considered within texts on traumatic stress and questions have been raised over the appropriateness of client-centred therapy with trauma survivors. The present study shows how, although he was writing well before the introduction of the term 'post-traumatic stress disorder', Carl Rogers provided a theory of therapy and personality that contains an account of threat-related psychological processes largely consistent with contemporary trauma theory. Rogers' theory provides the conceptual underpinnings to the client-centred and experiential ways of working with traumatized people. Furthermore, Rogers' theory provides an understanding of post-traumatic growth processes, and encourages therapists to adopt a more positive psychological perspective to their understanding of how people adjust to traumatic events.

  20. Personality, posttraumatic stress and trauma type: factors contributing to posttraumatic growth and its domains in a Turkish community sample

    Directory of Open Access Journals (Sweden)

    Ayse Nuray Karanci

    2012-06-01

    Full Text Available Background: Posttraumatic growth (PTG is conceptualized as a positive transformation resulting from coping with and processing traumatic life events. This study examined the contributory roles of personality traits, posttraumatic stress (PTS severity and their interactions on PTG and its domains, as assessed with the Posttraumatic Growth Inventory Turkish form (PTGI-T. The study also examined the differences in PTG domains between survivors of accidents, natural disasters and unexpected loss of a loved one. Methods: The Basic Personality Traits Inventory, Posttraumatic Diagnostic Scale, and PTGI-T were administered to a large stratified cluster community sample of 969 Turkish adults in their home settings. Results: The results showed that conscientiousness, agreeableness, and openness to experience significantly related to the total PTG and most of the domains. The effects of extraversion, neuroticism and openness to experience were moderated by the PTS severity for some domains. PTG in relating to others and appreciation of life domains was lower for the bereaved group. Conclusion: Further research should examine the mediating role of coping between personality and PTG using a longitudinal design.

  1. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework.

    Science.gov (United States)

    Ayers, S; Bond, R; Bertullies, S; Wijma, K

    2016-04-01

    There is evidence that 3.17% of women report post-traumatic stress disorder (PTSD) after childbirth. This meta-analysis synthesizes research on vulnerability and risk factors for birth-related PTSD and refines a diathesis-stress model of its aetiology. Systematic searches were carried out on PsycINFO, PubMed, Scopus and Web of Science using PTSD terms crossed with childbirth terms. Studies were included if they reported primary research that examined factors associated with birth-related PTSD measured at least 1 month after birth. In all, 50 studies (n = 21 429) from 15 countries fulfilled inclusion criteria. Pre-birth vulnerability factors most strongly associated with PTSD were depression in pregnancy (r = 0.51), fear of childbirth (r = 0.41), poor health or complications in pregnancy (r = 0.38), and a history of PTSD (r = 0.39) and counselling for pregnancy or birth (r = 0.32). Risk factors in birth most strongly associated with PTSD were negative subjective birth experiences (r = 0.59), having an operative birth (assisted vaginal or caesarean, r = 0.48), lack of support (r = -0.38) and dissociation (r = 0.32). After birth, PTSD was associated with poor coping and stress (r = 0.30), and was highly co-morbid with depression (r = 0.60). Moderator analyses showed that the effect of poor health or complications in pregnancy was more apparent in high-risk samples. The results of this meta-analysis are used to update a diathesis-stress model of the aetiology of postpartum PTSD and can be used to inform screening, prevention and intervention in maternity care.

  2. Exposure to political conflict and violence and posttraumatic stress in Middle East youth: protective factors.

    Science.gov (United States)

    Dubow, Eric F; Huesmann, L Rowell; Boxer, Paul; Landau, Simha; Dvir, Shira; Shikaki, Khalil; Ginges, Jeremy

    2012-01-01

    We examine the role of family- and individual-level protective factors in the relation between exposure to ethnic-political conflict and violence and posttraumatic stress among Israeli and Palestinian youth. Specifically, we examine whether parental mental health (lack of depression), positive parenting, children's self-esteem, and academic achievement moderate the relation between exposure to ethnic-political conflict/violence and subsequent posttraumatic stress (PTS) symptoms. We collected three waves of data from 901 Israeli and 600 Palestinian youths (three age cohorts: 8, 11, and 14 years old; approximately half of each gender) and their parents at 1-year intervals. Greater cumulative exposure to ethnic-political conflict/violence across the first 2 waves of the study predicted higher subsequent PTS symptoms even when we controlled for the child's initial level of PTS symptoms. This relation was significantly moderated by a youth's self-esteem and by the positive parenting received by the youth. In particular, the longitudinal relation between exposure to violence and subsequent PTS symptoms was significant for low self-esteem youth and for youth receiving little positive parenting but was non-significant for children with high levels of these protective resources. Our findings show that youth most vulnerable to PTS symptoms as a result of exposure to ethnic-political violence are those with lower levels of self-esteem and who experience low levels of positive parenting. Interventions for war-exposed youth should test whether boosting self-esteem and positive parenting might reduce subsequent levels of PTS symptoms.

  3. Role of trait shame in the association between posttraumatic stress and aggression among men with a history of interpersonal trauma.

    Science.gov (United States)

    Schoenleber, Michelle; Sippel, Lauren M; Jakupcak, Matthew; Tull, Matthew T

    2015-01-01

    Given the theoretical and empirical associations among posttraumatic stress, shame, and interpersonal aggression, this study examined whether trait shame accounts for the associations between posttraumatic stress and aggressive behavior in a sample of 103 men with a history of interpersonal trauma. Results indicated that trait shame accounted for the associations of posttraumatic stress with the variety of both physically and psychologically aggressive behavior, as well as with the frequency of physical aggression. This study also examined trait guilt, given its conceptual relationship to both shame and posttraumatic stress; unlike trait shame, trait guilt did not account for the association between posttraumatic stress and the variety of physically aggressive acts. Additionally, although trait guilt reduced the association between posttraumatic stress and the frequency of physical aggression, the indirect path including guilt was nonsignificant. Taken together, the present study supports existing theories suggesting that shame, but not guilt, may contribute to aggressive behavior, especially among individuals with histories of traumatic exposure.

  4. Treatment of sleep disturbances in posttraumatic stress disorder: A review

    Directory of Open Access Journals (Sweden)

    Frank B. Schoenfeld, MD

    2012-06-01

    Full Text Available Sleep disturbances are among the most commonly reported posttraumatic stress disorder (PTSD symptoms. It is essential to conduct a careful assessment of the presenting sleep disturbance to select the optimal available treatment. Cognitive-behavioral therapies (CBTs are at least as effective as pharmacologic treatment in the short-term and more enduring in their beneficial effects. Cognitive-behavioral treatment for insomnia and imagery rehearsal therapy have been developed to specifically treat insomnia and nightmares and offer promise for more effective relief of these very distressing symptoms. Pharmacotherapy continues to be an important treatment choice for PTSD sleep disturbances as an adjunct to CBT, when CBT is ineffective or not available, or when the patient declines CBT. Great need exists for more investigation into the effectiveness of specific pharmacologic agents for PTSD sleep disturbances and the dissemination of the findings to prescribers. The studies of prazosin and the findings of its effectiveness for PTSD sleep disturbance are examples of studies of pharmacologic agents needed in this area. Despite the progress made in developing more specific treatments for sleep disturbances in PTSD, insomnia and nightmares may not fully resolve.

  5. Update on post-traumatic stress syndrome after anesthesia.

    Science.gov (United States)

    Aceto, P; Perilli, V; Lai, C; Sacco, T; Ancona, P; Gasperin, E; Sollazzi, L

    2013-07-01

    Between 0.5% and 2% of surgical patients undergoing general anesthesia may experience awareness with explicit recall. These patients are at a risk for developing anxiety symptoms which may be transient or can lead to post-traumatic stress disorder (PTSD). The aim of this review was to assess the prevalence of PTSD after intraoperative awareness episodes and analyze patients' complaints, type and timing of assessment used. PubMed, MEDLINE and The Cochrane Library were searched up until October 2012. Prospective and retrospective studies on human adult subjects describing prevalence of PTSD and/or psychological sequalae after awareness episodes were included. Seven studies were identified. Prevalence of PTSD ranged from 0 to 71%. Acute emotions such as fear, panic, inability to communicate and feeling of helplessness were the only patients' complaints that were significantly correlated to psychological sequelae including PTDS. There were cases that reported psychological symptoms after 2-6 hours from awakening (%) or 30 days after (%). Previous studies used psychological scales lacking of dissociation assessment. Whenever an awareness episode is suspected, a psychological assessment with at least three interviews at 2-6 h, 2-36 h and 30 days must be performed in order to collect symptoms associated with both early and delayed retrieval of traumatic event. As a dissociative state could hide the expression of reactive symptoms after intraoperative awareness, future studies should be focused on detecting dissociative symptoms in order to carry out a prompt and appropriate treatment aimed at avoiding long-term psychological disability.

  6. Review of somatic symptoms in post-traumatic stress disorder.

    Science.gov (United States)

    Gupta, Madhulika A

    2013-02-01

    Post-traumatic stress disorder (PTSD) is associated with both (1) 'ill-defined' or 'medically unexplained' somatic syndromes, e.g. unexplained dizziness, tinnitus and blurry vision, and syndromes that can be classified as somatoform disorders (DSM-IV-TR); and (2) a range of medical conditions, with a preponderance of cardiovascular, respiratory, musculoskeletal, neurological, and gastrointestinal disorders, diabetes, chronic pain, sleep disorders and other immune-mediated disorders in various studies. Frequently reported medical co-morbidities with PTSD across various studies include cardiovascular disease, especially hypertension, and immune-mediated disorders. PTSD is associated with limbic instability and alterations in both the hypothalamic- pituitary-adrenal and sympatho-adrenal medullary axes, which affect neuroendocrine and immune functions, have central nervous system effects resulting in pseudo-neurological symptoms and disorders of sleep-wake regulation, and result in autonomic nervous system dysregulation. Hypervigilance, a central feature of PTSD, can lead to 'local sleep' or regional arousal states, when the patient is partially asleep and partially awake, and manifests as complex motor and/or verbal behaviours in a partially conscious state. The few studies of the effects of standard PTSD treatments (medications, CBT) on PTSD-associated somatic syndromes report a reduction in the severity of ill-defined and autonomically mediated somatic symptoms, self-reported physical health problems, and some chronic pain syndromes.

  7. Treatment of sleep disturbances in posttraumatic stress disorder: a review.

    Science.gov (United States)

    Schoenfeld, Frank B; Deviva, Jason C; Manber, Rachel

    2012-01-01

    Sleep disturbances are among the most commonly reported posttraumatic stress disorder (PTSD) symptoms. It is essential to conduct a careful assessment of the presenting sleep disturbance to select the optimal available treatment. Cognitive-behavioral therapies (CBTs) are at least as effective as pharmacologic treatment in the short-term and more enduring in their beneficial effects. Cognitive-behavioral treatment for insomnia and imagery rehearsal therapy have been developed to specifically treat insomnia and nightmares and offer promise for more effective relief of these very distressing symptoms. Pharmacotherapy continues to be an important treatment choice for PTSD sleep disturbances as an adjunct to CBT, when CBT is ineffective or not available, or when the patient declines CBT. Great need exists for more investigation into the effectiveness of specific pharmacologic agents for PTSD sleep disturbances and the dissemination of the findings to prescribers. The studies of prazosin and the findings of its effectiveness for PTSD sleep disturbance are examples of studies of pharmacologic agents needed in this area. Despite the progress made in developing more specific treatments for sleep disturbances in PTSD, insomnia and nightmares may not fully resolve.

  8. Updates on Pharmacological Treatment of Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Koirala, R; Søegaard, E G I; Thapa, S B

    2017-01-01

    Post-Traumatic Stress Disorder affects a significant proportion of those who have been exposed to exceptionally threatening or catastrophic events or situations such as earthquakes, rape and civil war. The condition can often become chronic and disabling. Medical intervention can therefore be of paramount importance. There are no national guidelines for trauma disorders in Nepal and there is a lack of adequate knowledge regarding drug treatment of PTSD among doctors and other service providers. Though psychotherapy is internationally regarded as the first line treatment for PTSD, it is often not feasible in Nepal due to lack of resources and skilled health workers in this field. The use of right psycho-pharmacotherapy is therefore important to reduce the burden of disease. A wide range of pharmacotherapy has been tested in the treatment of PTSD. This article is based on a selected sample of relevant articles from PubMed, PsycINFO, national guidelines from other countries and our own clinical experience. We have tried to give a concise and practical review regarding the use of drugs, their side effects and available evidence in the treatment of PTSD. The main findings point to use of Selective Serotonin Reuptake Inhibitors as the first line pharmacotherapy, and they can have effect on the full range of symptoms in PTSD. SNRIs show similar efficacy. Adjuvant drugs like Alpha-blockers and atypical antipsychotics have shown strong evidence in treating partially remitted cases and resolving ancillary symptoms.

  9. Pharmacological Prevention of Posttraumatic Stress Disorder: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Ravi Philip Rajkumar

    2014-01-01

    Full Text Available Introduction. Various interventions, both psychological and pharmacological, have been studied for their efficacy in preventing posttraumatic stress disorder (PTSD following trauma exposure. However, the preventive effect of pharmacotherapy has not been systematically assessed. Methodology. A systematic review of all clinical trials of drug therapy to prevent PTSD, available through the PubMed and EMBASE databases, was conducted. This included an assessment of each study’s quality. Results. A total of 13 studies were reviewed. The drugs examined in these papers included propranolol, hydrocortisone, serotonin reuptake inhibitors, gabapentin, omega-3 fatty acids, and benzodiazepines. There was marked heterogeneity across studies in terms of quality, study populations, and methodology. Analysis of the outcomes revealed preliminary evidence for the efficacy of hydrocortisone, particularly in critical care settings. There was no consistent evidence to support the use of other drugs to prevent PTSD. Discussion. There may be a limited role for hydrocortisone in preventing the development of PTSD in specific settings. Results with other drugs are inconsistent. Further large-scale studies should assess the efficacy of these approaches in other contexts, such as natural disasters, and the time frame within which they should be used.

  10. Post-traumatic stress disorder following disasters: a systematic review

    Science.gov (United States)

    Neria, Y.; Nandi, A.; Galea, S.

    2016-01-01

    Background Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters. Method A systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated. Results We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters (n=90), (2) technological disasters (n=65), and (3) natural disasters (n=116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together (n=13). Conclusions The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed. PMID:17803838

  11. Posttraumatic Stress Disorder in patients with traumatic brain injury

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    Schmidt Roger

    2004-03-01

    Full Text Available Abstract Background Severe traumatic stressors such as war, rape, or life-threatening accidents can result in a debilitating psychopathological development conceptualised as Posttraumatic Stress Disorder (PTSD. Pathological memory formation during an alarm response may set the precondition for PTSD to occur. If true, a lack of memory formation by extended unconsciousness in the course of the traumatic experience should preclude PTSD. Methods 46 patients from a neurological rehabilitation clinic were examined by means of questionnaires and structured clinical interviews. All patients had suffered a TBI due to an accident, but varied with respect to falling unconscious during the traumatic event. Results 27% of the sub-sample who were not unconscious for an extended period but only 3% (1 of 31 patients who were unconscious for more than 12 hours as a result of the accident were diagnosed as having current PTSD (P Conclusion TBI and PTSD are not mutually exclusive. However, victims of accidents are unlikely to develop a PTSD if the impact to the head had resulted in an extended period of unconsciousness.

  12. Posttraumatic stress disorder in a nationally representative mexican community sample.

    Science.gov (United States)

    Borges, Guilherme; Benjet, Corina; Petukhova, Maria; Medina-Mora, Maria Elena

    2014-06-01

    This study describes the public health burden of trauma exposure and posttraumatic stress disorder (PTSD) in relation to the full range of traumatic events to identify the conditional risk of PTSD from each traumatic event experienced in the Mexican population and other risk factors. The representative sample comprised a subsample (N = 2,362) of the urban participants of the Mexican National Comorbidity Survey (2001-2002). We used the World Health Organization's Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and the presence of PTSD according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, ) in each respondents' self-reported worst traumatic event, as well as a randomly selected lifetime trauma. The results showed that traumatic events were extremely common in Mexico (68.8%). The estimate of lifetime PTSD in the whole population was 1.5%; among only those with a traumatic event it was 2.1%. The 12-month prevalence of PTSD in the whole population was 0.6%; among only those with a traumatic event it was 0.8%. Violence-related events were responsible for a large share of PTSD. Sexual violence, in particular, was one of the greatest risks for developing PTSD. These findings support the idea that trauma in Mexico should be considered a public health concern.

  13. Properties of Swedish posttraumatic stress measures after a disaster.

    Science.gov (United States)

    Arnberg, Filip K; Michel, Per-Olof; Johannesson, Kerstin Bergh

    2014-05-01

    This study evaluated the properties of Swedish versions of self-report measures of posttraumatic stress disorder (PTSD), with emphasis on the Impact of Event Scale-Revised (IES-R). Survey data from adult survivors 1, 3, and 6 years after the 2004 Indian Ocean tsunami (n=1506) included the IES-R (from which the IES-6 was derived) and the 12-item General Health Questionnaire (GHQ-12). The PTSD Checklist (PCL) was included in one survey. A structured clinical interview was performed after 6 years (n=142). Factor analyses of the IES-R and PCL indicated that a dysphoric-arousal model provided good fit invariant across assessments. Both measures were accurate in excluding PTSD while all measures provided poorer positive predictive values. The IES-R, but not the IES-6 and GHQ-12, evidenced stability across assessments. In conclusion, the Swedish IES-R and PCL are sound measures of chronic PTSD, and the findings illustrate important temporal aspects of PTSD assessment.

  14. Posttraumatic Stress Disorder Following the September 11, 2001, Terrorist Attacks

    Science.gov (United States)

    Neria, Yuval; DiGrande, Laura; Adams, Ben G.

    2012-01-01

    The September 11, 2001 (9/11), terrorist attacks were unprecedented in their magnitude and aftermath. In the wake of the attacks, researchers reported a wide range of mental and physical health outcomes, with posttraumatic stress disorder (PTSD) the one most commonly studied. In this review, we aim to assess the evidence about PTSD among highly exposed populations in the first 10 years after the 9/11 attacks. We performed a systematic review. Eligible studies included original reports based on the full Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; American Psychiatric Association, 2000) criteria of PTSD among highly exposed populations such as those living or working within close proximity to the World Trade Center (WTC) and the Pentagon in New York City and Washington, DC, respectively, and first responders, including rescue, cleaning, and recovery workers. The large body of research conducted after the 9/11 attacks in the past decade suggests that the burden of PTSD among persons with high exposure to 9/11 was substantial. PTSD that was 9/11-related was associated with a wide range of correlates, including sociodemographic and background factors, event exposure characteristics, loss of life of significant others, and social support factors. Few studies used longitudinal study design or clinical assessments, and no studies reported findings beyond six years post-9/11, thus hindering documentation of the long-term course of confirmed PTSD. Future directions for research are discussed. PMID:21823772

  15. Predicting criminality from child maltreatment typologies and posttraumatic stress symptoms

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    Ask Elklit

    2013-04-01

    Full Text Available Background: The associations between childhood abuse and subsequent criminality and posttraumatic stress disorder (PTSD are well known. However, a major limitation of research related to childhood abuse and its effects is the focus on one particular type of abuse at the expense of others. Recent work has established that childhood abuse rarely occurs as a unidimensional phenomenon. Therefore, a number of studies have investigated the existence of abuse typologies. Methods: The study is based on a Danish stratified random probability survey including 2980 interviews of 24-year-old people. The sample was constructed to include an oversampling of child protection cases. Building on a previous latent class analysis of four types of childhood maltreatment, three maltreatment typologies were used in the current analyses. A criminality scale was constructed based on seven types of criminal behavior. PTSD symptoms were assessed by the PC-PTSD Screen. Results: Significant differences were found between the two genders with males reporting heightened rates of criminality. Furthermore, all three maltreatment typologies were associated with criminal behavior with odds ratios (ORs from 2.90 to 5.32. Female gender had an OR of 0.53 and possible PTSD an OR of 1.84. Conclusion: The independent association of participants at risk for PTSD and three types of maltreatment with criminality should be studied to determine if it can be replicated, and considered in social policy and prevention and rehabilitation interventions.

  16. Latent Factor Structure of DSM-5 Posttraumatic Stress Disorder

    Science.gov (United States)

    Gentes, Emily; Dennis, Paul A.; Kimbrel, Nathan A.; Kirby, Angela C.; Hair, Lauren P.; Beckham, Jean C.; Calhoun, Patrick S.

    2015-01-01

    The current study examined the latent factor structure of posttraumatic stress disorder (PTSD) based on DSM-5 criteria in a sample of participants (N = 374) recruited for studies on trauma and health. Confirmatory factor analyses (CFA) were used to compare the fit of the previous 3-factor DSM-IV model of PTSD to the 4-factor model specified in DSM-5 as well as to a competing 4-factor “dysphoria” model (Simms, Watson, & Doebbeling, 2002) and a 5-factor (Elhai et al., 2011) model of PTSD. Results indicated that the Elhai 5-factor model (re-experiencing, active avoidance, emotional numbing, dysphoric arousal, anxious arousal) provided the best fit to the data, although substantial support was demonstrated for the DSM-5 4-factor model. Low factor loadings were noted for two of the symptoms in the DSM-5 model (psychogenic amnesia and reckless/self-destructive behavior), which raises questions regarding the adequacy of fit of these symptoms with other core features of the disorder. Overall, the findings from the present research suggest the DSM-5 model of PTSD is a significant improvement over the previous DSM-IV model of PTSD. PMID:26366290

  17. Latent Factor Structure of DSM-5 Posttraumatic Stress Disorder.

    Science.gov (United States)

    Gentes, Emily; Dennis, Paul A; Kimbrel, Nathan A; Kirby, Angela C; Hair, Lauren P; Beckham, Jean C; Calhoun, Patrick S

    The current study examined the latent factor structure of posttraumatic stress disorder (PTSD) based on DSM-5 criteria in a sample of participants (N = 374) recruited for studies on trauma and health. Confirmatory factor analyses (CFA) were used to compare the fit of the previous 3-factor DSM-IV model of PTSD to the 4-factor model specified in DSM-5 as well as to a competing 4-factor "dysphoria" model (Simms, Watson, & Doebbeling, 2002) and a 5-factor (Elhai et al., 2011) model of PTSD. Results indicated that the Elhai 5-factor model (re-experiencing, active avoidance, emotional numbing, dysphoric arousal, anxious arousal) provided the best fit to the data, although substantial support was demonstrated for the DSM-5 4-factor model. Low factor loadings were noted for two of the symptoms in the DSM-5 model (psychogenic amnesia and reckless/self-destructive behavior), which raises questions regarding the adequacy of fit of these symptoms with other core features of the disorder. Overall, the findings from the present research suggest the DSM-5 model of PTSD is a significant improvement over the previous DSM-IV model of PTSD.

  18. Work-related post-traumatic stress disorder.

    Science.gov (United States)

    Skogstad, M; Skorstad, M; Lie, A; Conradi, H S; Heir, T; Weisæth, L

    2013-04-01

    Work-related post-traumatic stress disorder (PTSD) is an important condition encountered by many occupational health practitioners. To carry out an in-depth review of the research on occupational groups that are at particular risk of developing work-related PTSD. A literature search was conducted in the databases OVID MEDLINE, OVID Embase, Ovid PsycINFO, ISI Web of Science and CSA Health and Safety Science Abstracts. Professionals such as police officers, firefighters and ambulance personnel often experience incidents that satisfy the stressor criterion for the PTSD diagnosis. Other professional groups such as health care professionals, train drivers, divers, journalists, sailors and employees in bank, post offices or in stores may also be subjected to work-related traumatic events. Work-related PTSD usually diminishes with time. Mental health problems prior to the traumatic event and weak social support increase the risk of PTSD. Prevention of work-related PTSD includes a sound organizational and psychosocial work environment, systematic training of employees, social support from colleagues and managers and a proper follow-up of employees after a critical event.

  19. Post-traumatic stress disorder and traumatic brain injury.

    Science.gov (United States)

    Motzkin, Julian C; Koenigs, Michael R

    2015-01-01

    Disentangling the effects of "organic" neurologic damage and psychological distress after a traumatic brain injury poses a significant challenge to researchers and clinicians. Establishing a link between traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) has been particularly contentious, reflecting difficulties in establishing a unique diagnosis for conditions with overlapping and sometimes contradictory symptom profiles. However, each disorder is linked to a variety of adverse health outcomes, underscoring the need to better understand how neurologic and psychiatric risk factors interact following trauma. Here, we present data showing that individuals with a TBI are more likely to develop PTSD, and that individuals with PTSD are more likely to develop persistent cognitive sequelae related to TBI. Further, we describe neurobiological models of PTSD, highlighting how patterns of neurologic damage typical in TBI may promote or protect against the development of PTSD in brain-injured populations. These data highlight the unique course of PTSD following a TBI and have important diagnostic, prognostic, and treatment implications for individuals with a dual diagnosis.

  20. Post-traumatic stress disorder: a right temporal lobe syndrome?

    Science.gov (United States)

    Engdahl, B.; Leuthold, A. C.; Tan, H.-R. M.; Lewis, S. M.; Winskowski, A. M.; Dikel, T. N.; Georgopoulos, A. P.

    2010-12-01

    In a recent paper (Georgopoulos et al 2010 J. Neural Eng. 7 016011) we reported on the power of the magnetoencephalography (MEG)-based synchronous neural interactions (SNI) test to differentiate post-traumatic stress disorder (PTSD) subjects from healthy control subjects and to classify them with a high degree of accuracy. Here we show that the main differences in cortical communication circuitry between these two groups lie in the miscommunication of temporal and parietal and/or parieto-occipital right hemispheric areas with other brain areas. This lateralized temporal-posterior pattern of miscommunication was very similar but was attenuated in patients with PTSD in remission. These findings are consistent with observations (Penfield 1958 Proc. Natl Acad. Sci. USA 44 51-66, Penfield and Perot 1963 Brain 86 595-696, Gloor 1990 Brain 113 1673-94, Banceaud et al 1994 Brain 117 71-90, Fried 1997 J. Neuropsychiatry Clin. Neurosci. 9 420-8) that electrical stimulation of the temporal cortex in awake human subjects, mostly in the right hemisphere, can elicit the re-enactment and re-living of past experiences. Based on these facts, we attribute our findings to the re-experiencing component of PTSD and hypothesize that it reflects an involuntarily persistent activation of interacting neural networks involved in experiential consolidation.

  1. Prevalence and Correlates of Post-traumatic Stress Disorder in Adults With Congenital Heart Disease.

    Science.gov (United States)

    Deng, Lisa X; Khan, Abigail May; Drajpuch, David; Fuller, Stephanie; Ludmir, Jonathan; Mascio, Christopher E; Partington, Sara L; Qadeer, Ayesha; Tobin, Lynda; Kovacs, Adrienne H; Kim, Yuli Y

    2016-03-01

    Post-traumatic stress disorder (PTSD) is associated with adverse outcomes and increased mortality in cardiac patients. No studies have examined PTSD in the adult congenital heart disease (ACHD) population. The objectives of this study were to assess the prevalence of self-reported symptoms of PTSD in patients with ACHD and explore potential associated factors. Patients were enrolled from an outpatient ACHD clinic and completed several validated measures including the Impact of Event Scale-Revised, PTSD Checklist-Civilian Version, and the Hospital Anxiety and Depression Scale. Clinical data were abstracted through medical data review. A total of 134 participants (mean age 34.6 ± 10.6; 46% men) were enrolled. Of the 127 participants who completed the Impact of Event Scale-Revised, 14 (11%) met criteria for elevated PTSD symptoms specifically related to their congenital heart disease or treatment. Of the 134 patients who completed PTSD Checklist-Civilian Version, 27 (21%) met criteria for global PTSD symptoms. In univariate analyses, patients with congenital heart disease-specific PTSD had their most recent cardiac surgery at an earlier year (p = 0.008), were less likely to have attended college (p = 0.04), had higher rates of stroke or transient ischemic attack (p = 0.03), and reported greater depressive symptoms on the Hospital Anxiety and Depression Scale (7 vs 2, p PTSD were depressive symptoms (p PTSD is present in 11% to 21% of subjects seen at a tertiary referral center for ACHD. The high prevalence of PTSD in this complex group of patients has important implications for the medical and psychosocial management of this growing population.

  2. Exposure and peritraumatic response as predictors of posttraumatic stress in children following the 1995 Oklahoma City bombing

    OpenAIRE

    Pfefferbaum, Betty; Doughty, Debby E.; Reddy, Chandrashekar; Patel, Nilam; Gurwitch, Robin H.; Nixon, Sara Jo; Tivis, Rick D.

    2002-01-01

    Studies have demonstrated a positive relationship between exposure and posttraumatic stress, but one's subjective appraisal of danger and threat at the time of exposure may be a better predictor of posttraumatic stress than more objective measures of exposure. We examined the role of peritraumatic response in posttraumatic stress reactions in over 2,000 middle school children 7 weeks after the 1995 Oklahoma City, Oklahoma, bombing. While many children reported hearing and feeling the blast an...

  3. Amnestic disturbance and posttraumatic stress disorder in the aftermath of a chemical release.

    Science.gov (United States)

    Bowler, R M; Hartney, C; Ngo, L H

    1998-07-01

    Neuropsychological assessments were performed on 70 patients referred after a Catacarb chemical release in a Northern California town. After appropriate exclusions, the 59 patients used in the final analysis were mostly White (66%), with 56% having some college level education. They were administered the: Wechsler Adult Intelligence Scale-Revised (WAIS-R), Memory Assessment Scale (MAS), Trails A and B, Stroop, Controlled Oral Word Association Test (COWAT), Fingertapping Test, Purdue Pegboard, Dynamometer, Rey 15-Item Test, Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Brief Symptom Inventory (BSI), Beck Depression Index (BDI), Profile of Mood States (POMS), and Impact of Events Scale (IES) scales in addition to a health questionnaire and symptom checklist. Results indicate impaired scores on mnestic function and information processing when compared to Heaton's (1992) normative data, and the MAS norms (Williams, 1991). MMPI-2, BSI, BDI, POMS, and IES results indicate significant elevations on scales of depression, anxiety, anger, and posttraumatic stress disorder (PTSD) symptoms. The more brief tests of affect and mood appear sufficiently sensitive in measuring the dysphoric mood in group research studies. Clinical diagnoses using criteria from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994) criteria indicate a prevalence of 54% PTSD and 64% Amnestic or Cognitive disturbance. New onset of dermatological, respiratory, visual, and gastrointestinal symptoms and illnesses are consistent with the chemical exposure, the PTSD may be in reaction to it, and Amnestic/Cognitive disturbance, from both an organic and functional etiology.

  4. POSTTRAUMATIC STRESS DISORDER IN WOMEN WITH BINGE EATING DISORDER IN PRIMARY CARE

    Science.gov (United States)

    Grilo, Carlos M.; White, Marney A.; Barnes, Rachel D.; Masheb, Robin M.

    2012-01-01

    Background To examine the frequency and significance of comorbid posttraumatic stress disorder (PTSD) in ethnically diverse obese patients with binge eating disorder (BED) seeking treatment for obesity and binge eating in primary care. Methods Participants were a consecutive series of 105 obese women with BED; 43% were African-American, 36% were Caucasian, and 21% were Hispanic-American/other. Participants were evaluated with reliable semi-structured interviews and established measures. Results Of the 105 women, 25 (24%) met criteria for PTSD. PTSD was associated with significantly elevated rates of mood, anxiety, and drug use disorders, significantly elevated eating disorder psychopathology (Eating Disorder Examination global score and scales), greater depressive affect, and lower self-esteem, even though the patients with comorbid PTSD did not have higher body mass indexes (BMIs) or greater frequency of binge eating. The heightened eating disorder psychopathology and depression and the lower self-esteem among patients with comorbid PTSD persisted even after controlling for anxiety disorder comorbidity. Conclusions Our findings suggest that among ethnically/racially diverse obese women with BED who present for obesity and binge eating treatment in primary care settings, PTSD is common and is associated with heightened psychiatric comorbidity, greater eating disorder psychopathology, and poorer psychological functioning. PMID:23160245

  5. Self-mutilative behaviors in male veterans with posttraumatic stress disorder.

    Science.gov (United States)

    Sacks, Matthew B; Flood, Amanda M; Dennis, Michelle F; Hertzberg, Michael A; Beckham, Jean C

    2008-05-01

    Self-mutilative behaviors (SMB) were examined in a sample of male veterans with posttraumatic stress disorder (PTSD). The primary objective was to determine the prevalence of SMB and any physical, cognitive, or affective antecedents and correlates for these behaviors. Participants included 509 male veterans with PTSD and levels of PTSD, depression, alcohol use, hostility, and impulsivity were evaluated to determine if these variables were related to SMB. Antecedents and sequelae of SMB were also examined to generate hypotheses regarding the functions of these behaviors. A second type of habit behavior, body-focused repetitive behaviors (BFRB), was also examined as part of the study. Findings indicated that veterans who engaged in either type of habit behavior were younger than those who did not engage in SMB or BFRB. Veterans reporting SMB also reported higher levels of PTSD, depression, hostility, and impulsivity compared to the BFRB and no-habit groups. Examination of habit antecedents and sequelae showed support for the automatic-positive reinforcement function of SMB. These findings are discussed in the context of research and treatment involving male veterans with PTSD who engage in SMB.

  6. Validation of the French version of the Pittsburgh Sleep Quality Index Addendum for posttraumatic stress disorder

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    Malik Ait-Aoudia

    2013-09-01

    Full Text Available Background: Sleep disturbances are one of the main complaints of patients with trauma-related disorders. The original Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A is self-report instrument developed to evaluate posttraumatic stress disorder (PTSD-specific sleep disturbances in trauma-exposed individuals. However, to date, the PSQI-A has not yet been translated nor validated in French. Objective: The present study aims to: a translate the PSQI-A into French, and b examine its psychometric properties. Method: Seventy-three adult patients (mean age=40.3 [SD=15.0], 75% females evaluated in a specialized psychotraumatology unit completed the French versions of the PSQI-A, Pittsburgh Sleep Quality Index (PSQI, Hospital Anxiety and Depression Scale (HADS, and Impact Event Scale-Revised (IES-R. Results: The French version of the PSQI-A showed satisfactory internal consistency, inter-item correlations, item correlations with the total score, convergent validity with PTSD and anxiety measures, and divergent validity with a depression measure. Conclusion: Our findings support the use of the French version of the PSQI-A for both clinical care and research. The French version of the PSQI-A is an important addition to the currently available instruments that can be used to examine trauma-related sleep disturbances among French-speaking individuals.

  7. Posttraumatic stress disorder: prevalences, comorbidities and quality of life in a community sample of young adults

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    Letícia Galery Medeiros

    2015-03-01

    Full Text Available Objectives To verify the prevalence of current posttraumatic stress disorder (PTSD in young adults, the occurrence of comorbidities and its association with quality of life. Methods This is a cross-sectional population-based study. The targeted population consisted on individuals aged 18 to 24 years old, who lived in the urban area of Pelotas-RS, Brazil. Cluster sampling was applied. PTSD and its comorbidities were assessed using the Mini International Neuropsychiatric Interview (MINI 5.0, whereas quality of life was evaluated with the eight domains of the Medical Outcomes Survey Short-form General Health Survey (SF-36. Results A total of 1,762 young adults were selected. The prevalence of PTSD was 2.1% and current episode of depression was the most prevalent comorbidity (71.9%. The individuals with PTSD had lower scores in all domains of quality of life. Conclusion These findings indicate that PTSD is associated with other psychopathologies, especially depression, and it has a substantial impact over quality of life in a sample of young adults.

  8. Dissociative subtype of DSM-5 posttraumatic stress disorder in U.S. veterans.

    Science.gov (United States)

    Tsai, Jack; Armour, Cherie; Southwick, Steven M; Pietrzak, Robert H

    2015-01-01

    The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) formally introduced a dissociative subtype of posttraumatic stress disorder (PTSD). This study examined the proportion of U.S. veterans with DSM-5 PTSD that report dissociative symptoms; and compared veterans with PTSD with and without the dissociative subtype and trauma-exposed controls on sociodemographics, clinical characteristics, and quality of life. Multivariable analyses were conducted on a nationally representative sample of 1484 veterans from the National Health and Resilience in Veterans Study (second baseline survey conducted September-October, 2013). Of the 12.0% and 5.2% of veterans who screened positive for lifetime and past-month DSM-5 PTSD, 19.2% and 16.1% screened positive for the dissociative subtype, respectively. Among veterans with PTSD, those with the dissociative subtype reported more severe PTSD symptoms, comorbid depressive and anxiety symptoms, alcohol use problems, and hostility than those without the dissociative subtype. Adjusting for PTSD symptom severity, those with the dissociative subtype continued to report more depression and alcohol use problems. These results underscore the importance of assessing, monitoring, and treating the considerable proportion of veterans with PTSD and dissociative symptoms. Published by Elsevier Ltd.

  9. Post-traumatic stress disorder and suicide risk: a systematic review.

    Science.gov (United States)

    Krysinska, Karolina; Lester, David

    2010-01-01

    There is a gap in the literature regarding suicide risk among traumatized individuals with post-traumatic stress disorder (PTSD) and this article aims to systematically review literature on the relationship between PTSD and suicidal behavior and ideation. A meta-analysis of 50 articles that examined the association between PTSD and past and current suicidal ideation and behavior was conducted. There was no evidence for an increased risk of completed suicide in individuals with PTSD. PTSD was associated with an increased incidence of prior attempted suicide and prior and current suicidal ideation. Controlling for other psychiatric disorders (including depression) weakened, but did not eliminate, this association. The evidence indicates that there is an association between PTSD and suicidality with several factors, such as concurrent depression and the pre-trauma psychiatric condition, possibly mediating this relationship. There are significant clinical implications of the reported relationship for suicide risk assessment and therapy, and further studies might help to understand the mediating pathways between PTSD and increased suicide risk.

  10. An empirical investigation of suicide schemas in individuals with Posttraumatic Stress Disorder.

    Science.gov (United States)

    Panagioti, Maria; Gooding, Patricia A; Pratt, Daniel; Tarrier, Nicholas

    2015-06-30

    Posttraumatic Stress Disorder (PTSD) has been strongly associated with suicidality. Despite the growing evidence suggesting that suicidality is heightened by the presence of an elaborated suicide schema, investigations of suicide schemas are sparse. Using novel methodologies, this study aimed to compare the suicide schema of PTSD individuals with and without suicidal ideation in the past year. Fifty-six participants with a diagnosis of PTSD (confirmed via the Clinician Administered PTSD Scale) completed questionnaires to assess suicidality, depressive severity and hopelessness. A series of direct and indirect cognitive tasks were used to assess suicide schemas. The pathfinder technique was employed to construct graphical representations of the groups׳ suicide schemas. The suicidal group reported significantly more severe PTSD symptoms, depressive symptoms, hopelessness and suicidality. The suicide schema of the suicidal group was significantly more extensive compared to the non-suicidal group even after taking into account in the analyses group differences in clinical measures. Moreover, the suicide schemas of the two groups were qualitatively distinct from each other. These findings provide support for contemporary theories of suicide which view suicide schemas as an important indicator of suicide risk. The investigation of schema constructs opens a new avenue of research for understanding suicide.

  11. Maternal Posttraumatic Stress Symptoms and Infant Emotional Reactivity and Emotion Regulation

    Science.gov (United States)

    Enlow, Michelle Bosquet; Kitts, Robert L.; Blood, Emily; Bizarro, Andrea; Hofmeister, Michelle; Wright, Rosalind J.

    2011-01-01

    The current study examined associations between maternal posttraumatic stress disorder (PTSD) symptoms and infant emotional reactivity and emotion regulation during the first year of life in a primarily low-income, urban, ethnic/racial minority sample of 52 mother-infant dyads. Mothers completed questionnaires assessing their own trauma exposure history and current PTSD and depressive symptoms and their infants’ temperament when the infants were 6 months old. Dyads participated in the repeated Still-Face Paradigm (SFP-R) when the infants were 6 months old, and infant affective states were coded for each SFP-R episode. Mothers completed questionnaires assessing infant trauma exposure history and infant current emotional and behavioral symptoms when the infants were 13 months old. Maternal PTSD symptoms predicted infants’ emotion regulation at 6 months as assessed by (a) infant ability to recover from distress during the SFP-R and (b) maternal report of infant rate of recovery from distress/arousal in daily life. Maternal PTSD symptoms also predicted maternal report of infant externalizing, internalizing, and dysregulation symptoms at 13 months. Maternal PTSD was not associated with measures of infant emotional reactivity. Neither maternal depressive symptoms nor infant direct exposure to trauma accounted for the associations between maternal PTSD symptoms and infant outcomes. These findings suggest that maternal PTSD is associated with offspring emotion regulation difficulties as early as infancy. Such difficulties may contribute to increased risk of mental health problems among children of mothers with PTSD. PMID:21862136

  12. Abnormal emotional processing in maltreated children diagnosed of Complex Posttraumatic Stress Disorder.

    Science.gov (United States)

    Bertó, Clara; Ferrin, Maite; Barberá, María; Livianos, Lorenzo; Rojo, Luis; García-Blanco, Ana

    2017-09-22

    Maltreated children usually show a specific pattern of emotional and behavioral symptoms that exceed those relating to posttraumatic stress disorder (PTSD). These symptoms have been defined as Complex PTSD (CPTSD). The underlying attentional mechanisms of abnormal emotional processing and their relation to the clinical presentation of CPTSD are not well understood. A visual dot-probe paradigm involving pre-attentive (i.e., 500ms) and attentive (i.e., 1500ms) presentation rates of neutral versus emotional (i.e., angry, happy or sad) facial expressions was applied. Twenty-one maltreated CPTSD children were compared with twenty-six controls. The results are as follows: an attention bias away from threatening faces and an attentional bias towards sad faces were observed in maltreated CPTSD children during pre-attentive and attentive processing. Whereas the attentional bias away from angry faces was associated with social problems, the attentional bias towards sad faces was associated with depressive and withdrawn symptoms. Therefore, CPTSD children develop maladaptive negative cognitive styles, which may underlie not only social problems (by a cognitive avoidance of threatening stimuli) but also depressive symptoms (by a cognitive approach to sad stimuli). Attention processing abnormalities should be considered as therapeutic targets for new treatment approaches in this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Risk factors predict post-traumatic stress disorder differently in men and women

    Directory of Open Access Journals (Sweden)

    Elklit Ask

    2008-11-01

    Full Text Available Abstract Background About twice as many women as men develop post-traumatic stress disorder (PTSD, even though men as a group are exposed to more traumatic events. Exposure to different trauma types does not sufficiently explain why women are more vulnerable. Methods The present work examines the effect of age, previous trauma, negative affectivity (NA, anxiety, depression, persistent dissociation, and social support on PTSD separately in men and women. Subjects were exposed to either a series of explosions in a firework factory near a residential area or to a high school stabbing incident. Results Some gender differences were found in the predictive power of well known risk factors for PTSD. Anxiety predicted PTSD in men, but not in women, whereas the opposite was found for depression. Dissociation was a better predictor for PTSD in women than in men in the explosion sample but not in the stabbing sample. Initially, NA predicted PTSD better in women than men in the explosion sample, but when compared only to other significant risk factors, it significantly predicted PTSD for both men and women in both studies. Previous traumatic events and age did not significantly predict PTSD in either gender. Conclusion Gender differences in the predictive value of social support on PTSD appear to be very complex, and no clear conclusions can be made based on the two studies included in this article.

  14. Prevalence and correlates of cannabis use in an outpatient VA posttraumatic stress disorder clinic.

    Science.gov (United States)

    Gentes, Emily L; Schry, Amie R; Hicks, Terrell A; Clancy, Carolina P; Collie, Claire F; Kirby, Angela C; Dennis, Michelle F; Hertzberg, Michael A; Beckham, Jean C; Calhoun, Patrick S

    2016-05-01

    Recent research has documented high rates of comorbidity between cannabis use disorders and posttraumatic stress disorder (PTSD) in veterans. However, despite possible links between PTSD and cannabis use, relatively little is known about cannabis use in veterans who present for PTSD treatment, particularly among samples not diagnosed with a substance use disorder. This study examined the prevalence of cannabis use and the psychological and functional correlates of cannabis use among a large sample of veterans seeking treatment at a Veterans Affairs (VA) PTSD specialty clinic. Male veterans (N = 719) who presented at a VA specialty outpatient PTSD clinic completed measures of demographic variables, combat exposure, alcohol, cannabis and other drug use, and PTSD and depressive symptoms. The associations among demographic, psychological, and functional variables were estimated using logistic regressions. Overall, 14.6% of participants reported using cannabis in the past 6 months. After controlling for age, race, service era, and combat exposure, past 6-month cannabis use was associated with unmarried status, use of tobacco products, other drug use, hazardous alcohol use, PTSD severity, depressive symptom severity, and suicidality. The present findings show that cannabis use is quite prevalent among veterans seeking PTSD specialty treatment and is associated with poorer mental health and use of other substances. It may be possible to identify and treat individuals who use cannabis in specialty clinics (e.g., PTSD clinics) where they are likely to present for treatment of associated mental health issues. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  15. Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident.

    Science.gov (United States)

    Bae, Sung-Man; Hyun, Myoung-Ho; Lee, Seung-Hwan

    2014-04-01

    Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered. There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group. Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.

  16. Rates of trauma spectrum disorders and risks of posttraumatic stress disorder in a sample of orphaned and widowed genocide survivors

    Directory of Open Access Journals (Sweden)

    Susanne Schaal

    2011-06-01

    Full Text Available During the Rwandan genocide of 1994, nearly one million people were killed within a period of 3 months.The objectives of this study were to investigate the levels of trauma exposure and the rates of mental health disorders and to describe risk factors of posttraumatic stress reactions in Rwandan widows and orphans who had been exposed to the genocide.Trained local psychologists interviewed orphans (n=206 and widows (n=194. We used the PSS-I to assess posttraumatic stress disorder (PTSD, the Hopkins Symptom Checklist to assess depression and anxiety symptoms, and the M.I.N.I. to assess risk of suicidality.Subjects reported having been exposed to a high number of different types of traumatic events with a mean of 11 for both groups. Widows displayed more severe mental health problems than orphans: 41% of the widows (compared to 29% of the orphans met symptom criteria for PTSD and a substantial proportion of widows suffered from clinically significant depression (48% versus 34% and anxiety symptoms (59% versus 42% even 13 years after the genocide. Over one-third of respondents of both groups were classified as suicidal (38% versus 39%. Regression analysis indicated that PTSD severity was predicted mainly by cumulative exposure to traumatic stressors and by poor physical health status. In contrast, the importance given to religious/spiritual beliefs and economic variables did not correlate with symptoms of PTSD.While a significant portion of widows and orphans continues to display severe posttraumatic stress reactions, widows seem to constitute a particularly vulnerable survivor group. Our results point to the chronicity of mental health problems in this population and show that PTSD may endure over time if not addressed by clinical intervention. Possible implications of poor mental health and the need for psychological intervention are discussed.

  17. Indian Ocean tsunami: relationships among posttraumatic stress, posttraumatic growth, resource loss, and coping at 3 and 15 months.

    Science.gov (United States)

    Sattler, David N; Assanangkornchai, Sawitri; Moller, Adam M; Kesavatana-Dohrs, Wiworn; Graham, James M

    2014-01-01

    This study examines variables associated with posttraumatic stress symptoms (PTS) and posttraumatic growth among 2 independent samples of survivors following the Indian Ocean tsunami in Khao Lak, Thailand. Participants were exposed to unprecedented horror and loss of life and property. At 3 months participants (N = 248) were living in temporary shelters, and at 15 months a second sample (N = 255) was living in homes built after the tsunami. Prior traumatic experiences, life threat, loss of personal characteristic resources and condition resources, somatic problems, and social support accounted for close to half of the variance in PTS in each sample. At 3 months, emotion-focused coping and concerns about government favoritism also contributed to PTS. At 15 months, lack of prior disaster experience and loss of energy resources also contributed to PTS. Distress was higher among participants surveyed at 3 months than among those surveyed at 15 months. Posttraumatic growth was positively associated with social support and problem-focused coping in both samples. The findings support conservation of resources stress theory ( Hobfoll, 2012 ) and underscore how systemic issues affect mental health. The implications of the findings are discussed, as is the educational International Tsunami Museum designed by the first author to address systemic stressors.

  18. Correlation Between Posttraumatic Growth and Posttraumatic Stress Disorder Symptoms Based on Pearson Correlation Coefficient: A Meta-Analysis.

    Science.gov (United States)

    Liu, An-Nuo; Wang, Lu-Lu; Li, Hui-Ping; Gong, Juan; Liu, Xiao-Hong

    2016-11-22

    The literature on posttraumatic growth (PTG) is burgeoning, with the inconsistencies in the literature of the relationship between PTG and posttraumatic stress disorder (PTSD) symptoms becoming a focal point of attention. Thus, this meta-analysis aims to explore the relationship between PTG and PTSD symptoms through the Pearson correlation coefficient. A systematic search of the literature from January 1996 to November 2015 was completed. We retrieved reports on 63 studies that involved 26,951 patients. The weighted correlation coefficient revealed an effect size of 0.22 with a 95% confidence interval of 0.18 to 0.25. Meta-analysis provides evidence that PTG may be positively correlated with PTSD symptoms and that this correlation may be modified by age, trauma type, and time since trauma. Accordingly, people with high levels of PTG should not be ignored, but rather, they should continue to receive help to alleviate their PTSD symptoms.

  19. Stresses and Disability in Depression across Gender

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    Sharmishtha S. Deshpande

    2014-01-01

    Full Text Available Depression, though generally episodic, results in lasting disability, distress, and burden. Rising prevalence of depression and suicide in the context of epidemiological transition demands more attention to social dimensions like gender related stresses, dysfunction, and their role in outcome of depression. Cross-sectional and follow-up assessment of men and women with depression at a psychiatric tertiary centre was undertaken to compare their illness characteristics including suicidal ideation, stresses, and functioning on GAF, SOFAS, and GARF scales (N=107. We reassessed the patients on HDRS-17 after 6 weeks of treatment. Paired t-test and chi-square test of significance were used to compare the two groups, both before and after treatment. Interpersonal and marital stresses were reported more commonly by women (P<0.001 and financial stresses by men (P<0.001 though relational functioning was equally impaired in both. Women had suffered stresses for significantly longer duration (P=0.0038. Men had more impairment in social and occupational functioning compared to females (P=0.0062. History of suicide attempts was significantly associated with more severe depression and lower levels of functioning in case of females with untreated depression. Significant cross-gender differences in stresses, their duration, and types of dysfunction mandate focusing on these aspects over and above the criterion-based diagnosis.

  20. The posttraumatic stress disorder project in Brazil: neuropsychological, structural and molecular neuroimaging studies in victims of urban violence

    Directory of Open Access Journals (Sweden)

    Bressan Rodrigo A

    2009-06-01

    Clinical Interview for DSM-IV and the Clinician-Administered PTSD Scale, Beck Anxiety Inventory, Beck Depression Inventory, Global Assessment of Function, The Social Adjustment Scale, Medical Outcomes Study 36-Item Short-Form Health Survey, Early Trauma Inventory, Clinical global Impressions, and Peritraumatic Dissociative Experiences Questionnaire. A broad neuropsychological battery will be administered for all participants of the neuropsychological study. Magnetic resonance scans will be performed to acquire structural neuroimaging data. Single photon emission computerized tomography with [(99mTc]-TRODAT-1 brain scans will be performed to evaluate dopamine transporters. Discussion This study protocol will be informative for researchers and clinicians interested in considering, designing and/or conducting translational research in the field of trauma and posttraumatic stress disorder.

  1. Clinical feasibility of cervical exercise to improve neck pain, body function, and psychosocial factors in patients with post-traumatic stress disorder: a randomized controlled trial.

    Science.gov (United States)

    Park, Seong Doo; Kim, Suhn Yeop

    2015-05-01

    [Purpose] To investigate the effect of cervical exercise on neck pain, disability, and psychosocial factors in patients with post-traumatic stress disorder. [Subjects] Thirty patients with post-traumatic stress disorder, who also complained of neck pain. [Methods] The cervical exercise group (n = 15) participated in cervical exercises for 30 min, 3 times/week for 6 weeks, and the control group (n = 16) underwent conventional physical therapy alone, without exercise. The exercises were performed in the following order: cervical relaxation, local muscle stabilization, and global muscle stabilization using a sling system. [Results] Compared to the control group, the cervical exercise group demonstrated significant decreases as follows: Visual analogue scale score, 4.2 vs. 1.0; Neck disability index, 3.9 vs. 1.9; and depression on the Symptom checklist-90-revised, 9.4 vs. 4.3 and on the Hopkins symptom checklist-25, 6.3 vs. 2.8. However, anxiety on the Symptom checklist-90-revised (3.1 vs. 1.3) was not significantly different. Effect sizes were as follows: Visual analogue scale score, 1.8; Neck disability index, 0.9; depression, 1.0; and anxiety on Symptom checklist-90-revised and Hopkins symptom checklist-25, 0.6 and 0.8, respectively. [Conclusion] Cervical exercise is effective in improving neck pain, disability, and efficacy of psychological treatment for depression in patients with post-traumatic stress disorder.

  2. Complex post-traumatic stress disorder in patients with somatization disorder.

    Science.gov (United States)

    Spitzer, Carsten; Barnow, Sven; Wingenfeld, Katja; Rose, Matthias; Löwe, Bernd; Grabe, Hans Joergen

    2009-01-01

    Given the association between severe childhood trauma, adult somatization and complex post-traumatic stress disorder (cPTSD), the purpose of the present paper was to assess this syndrome and its clinical correlates in patients with somatization disorder (SD). A total of 28 patients (82% women, mean age = 41.7+/-10.1 years) meeting DSM-IV criteria for SD as confirmed by the Structured Clinical Interview for DSM-IV, Axis I were compared to 28 age- and gender-matched patients with major depression, but without a lifetime diagnosis of SD. They completed the Structured Interview for Disorders of Extreme Stress, the Brief Symptom Inventory, the Inventory of Interpersonal Problems-Circumplex Scales, and the SF-36 Health Survey. Compared to the control group, SD patients had higher risks for current and lifetime diagnoses of cPTSD (odds ratio (OR) = 15.0, 95% confidence interval (CI) = 1.76-127.54; and OR = 8.33, 95%CI = 2.04-34.07, respectively). SD subjects with cPTSD had more psychological distress, more interpersonal problems and worse psychosocial functioning than those without the syndrome. The concept of complex PTSD may hold clinical utility when applied to SD patients because it identifies a distinct subgroup characterized by severe psychosocial impairment. The diagnostic and therapeutic implications of the present findings are discussed.

  3. Impact of Traumatic Events on Posttraumatic Stress Disorder among Danish Survivors of Sexual Abuse in Childhood

    DEFF Research Database (Denmark)

    Elklit, Ask; Christiansen, Dorte Mølgaard; Palic, Sabina

    2014-01-01

    Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse...... survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk...... factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute...

  4. Psychobiology of posttraumatic stress disorder in pediatric injury patients: a review of the literature.

    Science.gov (United States)

    Langeland, Willie; Olff, Miranda

    2008-01-01

    Research suggests that about a quarter to a third of children with traffic-related injuries develop posttraumatic stress disorder (PTSD). Early symptoms of PTSD have been found to predict poor mental and physical outcome in studies of medically injured children. However, these symptoms are rarely recognized by physicians who provide emergency care for these children. In addition, there is insufficient knowledge about predictors of posttraumatic stress symptoms in this specific pediatric population. Early identification of those children at particular risk is needed to target preventive interventions appropriately. After some introducing remarks on the classification and the nature of posttraumatic stress reactions, current research findings on psychological and biological correlates of PTSD in pediatric injury patients are presented. The particular focus in this paper is on the neurobiological mechanisms that influence psychological responses to extreme stress and the development of PTSD. Continued study of the psychobiology of trauma and PTSD in pediatric injury patients, both in terms of neurobiology and treatment is needed.

  5. Pre-trauma individual differences in extinction learning predict posttraumatic stress.

    Science.gov (United States)

    Lommen, Miriam J J; Engelhard, Iris M; Sijbrandij, Marit; van den Hout, Marcel A; Hermans, Dirk

    2013-02-01

    In the aftermath of a traumatic event, many people suffer from psychological distress, but only a minority develops posttraumatic stress disorder (PTSD). Pre-trauma individual differences in fear conditioning, most notably reduced extinction learning, have been proposed as playing an important role in the etiology of PTSD. However, prospective data are lacking. In this study, we prospectively tested whether reduced extinction was a predictor for later posttraumatic stress. Dutch soldiers (N = 249) were administered a conditioning task before their four-month deployment to Afghanistan to asses individual differences in extinction learning. After returning home, posttraumatic stress was measured. Results showed that reduced extinction learning before deployment predicted subsequent PTSD symptom severity, over and beyond degree of pre-deployment stress symptoms, neuroticism, and exposure to stressors on deployment. The findings suggest that reduced extinction learning may play a role in the development of PTSD.

  6. Predicting violence in veterans with posttraumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Jovanović Aleksandar A.

    2009-01-01

    Full Text Available Background/Aim. Frequent expression of negative affects, hostility and violent behavior in individuals suffering from posttraumatic stress disorder (PTSD were recognized long ago, and have been retrospectively well documented in war veterans with PTSD who were shown to have an elevated risk for violent behavior when compared to both veterans without PTSD and other psychiatric patients. The aim of this study was to evaluate the accuracy of clinical prediction of violence in combat veterans suffering from PTSD. Methods. The subjects of this study, 104 male combat veterans with PTSD were assessed with the Historical, Clinical and Risk Management 20 (HCR-20, a 20-item clinicianrated instrument for assessing the risks for violence, and their acts of violence during one-year follow-up period were registered based on bimonthly check-up interviews. Results. Our findings showed that the HCR-20, as an actuarial measure, had good internal consistency reliability (α = 0.82, excellent interrater reliability (Interaclass Correlation ICC = 0.85, as well as excellent predictive validity for acts of any violence, non-physical violence or physical violence in the follow-up period (AUC = 0.82-0.86. The HCR-20 also had good interrater reliability (Cohen's kappa = 0.74, and acceptable predictive accuracy for each outcome criterion (AUC = 0.73-0.79. Conclusion. The results of this research confirm that the HCR-20 may also be applied in prediction of violent behavior in the population of patients suffering from PTSD with reliability and validity comparable with the results of previous studies where this instrument was administered to other populations of psychiatric patients.

  7. The auditory startle response in post-traumatic stress disorder.

    Science.gov (United States)

    Siegelaar, S E; Olff, M; Bour, L J; Veelo, D; Zwinderman, A H; van Bruggen, G; de Vries, G J; Raabe, S; Cupido, C; Koelman, J H T M; Tijssen, M A J

    2006-09-01

    Post-traumatic stress disorder (PTSD) patients are considered to have excessive EMG responses in the orbicularis oculi (OO) muscle and excessive autonomic responses to startling stimuli. The aim of the present study was to gain more insight into the pattern of the generalized auditory startle reflex (ASR). Reflex EMG responses to auditory startling stimuli in seven muscles rather than the EMG response of the OO alone as well as the psychogalvanic reflex (PGR) were studied in PTSD patients and healthy controls. Ten subjects with chronic PTSD (>3 months) and a history of excessive startling and 11 healthy controls were included. Latency, amplitude and duration of the EMG responses and the amplitude of the PGR to 10 auditory stimuli of 110 dB SPL were investigated in seven left-sided muscles. The size of the startle reflex, defined by the number of muscles activated by the acoustic stimulus and by the amplitude of the EMG response of the OO muscle as well, did not differ significantly between patients and controls. Median latencies of activity in the sternocleidomastoid (SC) (patients 80 ms; controls 54 ms) and the deltoid (DE) muscles (patients 113 ms; controls 69 ms) were prolonged significantly in PTSD compared to controls (P < 0.05). In the OO muscle, a late response (median latency in patients 308 ms; in controls 522 ms), probably the orienting reflex, was more frequently present in patients (56%) than in controls (12%). In patients, the mean PGR was enlarged compared to controls (P < 0.05). The size of the ASR response is not enlarged in PTSD patients. EMG latencies in the PTSD patients are prolonged in SC and DE muscles. The presence of a late response in the OO muscle discriminates between groups of PTSD patients with a history of startling and healthy controls. In addition, the autonomic response, i.e. the enlarged amplitude of the PGR can discriminate between these groups.

  8. Trauma, posttraumatic stress disorder and psychosis: etiopathogenic and nosological implications

    Directory of Open Access Journals (Sweden)

    Álvaro Frías Ibáñez

    2014-03-01

    Full Text Available Background and Objectives: The relationship between trauma, post-traumatic stress disorder (PTSD, and psychosis has promoted heterogeneous research lines, in both etiopathogenic and nosological areas. The main aim of this review is to provide a systematic framework that encompasses this theoretical gap in the literature. Methods: A literature research was carried out through PubMed and PsycINFO between 1980 and May 2013. One hundred and thirteen articles were recruited. A first part of this review describes the role of trauma in the development of psychosis. The second part focuses on research about PTSD and psychosis. Results: Longitudinal and cross-sectional studies with clinical and community samples confirm that childhood trauma (CT is a vulnerability factor for schizophrenia and psychotic-like symptoms in adulthood. More empirical research is needed in order to assess the role of trauma as precipitant of acute psychosis. There is also preliminary evidence with cross-sectional samples that suggests that PTSD and psychosis are a risk factor for each other, with studies about post-psychotic PTSD (PP-PTSD being outstanding. Finally, results from different comparative research studies postulate a subtype of PTSD with psychotic features (PTSD-SP. Conclusions: The role of trauma in psychosis is more conclusive as predispositional rather than as trigger factor. Nosological status of acute psychoses remains a focus of controversy unresolved. The association between PTSD and psychosis is complex, requiring more prospective research in order to determine causal relationships between these pathologies. Also, research in nosological status of PTSD-SP must encourage more comparative studies not limited to neurobiological variables.

  9. Smoking and Posttraumatic Stress Disorder Symptomatology in Orofacial Pain

    Science.gov (United States)

    Weber, T.; Boggero, I.A.; Carlson, C.R.; Bertoli, E.; Okeson, J.P.; de Leeuw, R.

    2016-01-01

    To explore the impact of interactions between smoking and symptoms of posttraumatic stress disorder (PTSD) on pain intensity, psychological distress, and pain-related functioning in patients with orofacial pain, a retrospective review was conducted of data obtained during evaluations of 610 new patients with a temporomandibular disorder who also reported a history of a traumatic event. Pain-related outcomes included measures of pain intensity, psychological distress, and pain-related functioning. Main effects of smoking status and PTSD symptom severity on pain-related outcomes were evaluated with linear regression analyses. Further analyses tested interactions between smoking status and PTSD symptom severity on pain-related outcomes. PTSD symptom severity and smoking predicted worse pain-related outcomes. Interaction analyses between PTSD symptom severity and smoking status revealed that smoking attenuated the impact of PTSD symptom severity on affective distress, although this effect was not found at high levels of PTSD symptom severity. No other significant interactions were found, but the present results identifying smoking as an ineffective coping mechanism and the likely role of inaccurate outcome expectancies support the importance of smoking cessation efforts in patients with orofacial pain. Smoking is a maladaptive mechanism for coping with pain that carries significant health- and pain-related risks while failing to fulfill smokers’ expectations of affect regulation, particularly among persons with orofacial pain who also have high levels of PTSD symptom severity. Addressing smoking cessation is a critical component of comprehensive treatment. Further research is needed to develop more effective ways to help patients with pain and/or PTSD to replace smoking with more effective coping strategies. PMID:27486084

  10. Smoking and Posttraumatic Stress Disorder Symptomatology in Orofacial Pain.

    Science.gov (United States)

    Weber, T; Boggero, I A; Carlson, C R; Bertoli, E; Okeson, J P; de Leeuw, R

    2016-09-01

    To explore the impact of interactions between smoking and symptoms of posttraumatic stress disorder (PTSD) on pain intensity, psychological distress, and pain-related functioning in patients with orofacial pain, a retrospective review was conducted of data obtained during evaluations of 610 new patients with a temporomandibular disorder who also reported a history of a traumatic event. Pain-related outcomes included measures of pain intensity, psychological distress, and pain-related functioning. Main effects of smoking status and PTSD symptom severity on pain-related outcomes were evaluated with linear regression analyses. Further analyses tested interactions between smoking status and PTSD symptom severity on pain-related outcomes. PTSD symptom severity and smoking predicted worse pain-related outcomes. Interaction analyses between PTSD symptom severity and smoking status revealed that smoking attenuated the impact of PTSD symptom severity on affective distress, although this effect was not found at high levels of PTSD symptom severity. No other significant interactions were found, but the present results identifying smoking as an ineffective coping mechanism and the likely role of inaccurate outcome expectancies support the importance of smoking cessation efforts in patients with orofacial pain. Smoking is a maladaptive mechanism for coping with pain that carries significant health- and pain-related risks while failing to fulfill smokers' expectations of affect regulation, particularly among persons with orofacial pain who also have high levels of PTSD symptom severity. Addressing smoking cessation is a critical component of comprehensive treatment. Further research is needed to develop more effective ways to help patients with pain and/or PTSD to replace smoking with more effective coping strategies.

  11. DIAGNOSTIC CHALLENGES IN ASSESSING POST-TRAUMATIC STRESS DISORDER.

    Directory of Open Access Journals (Sweden)

    Mariana Arnaudova

    2015-12-01

    Full Text Available Post-traumatic stress disorder (PTSD is one of those psychiatric disorders that are still away from our attention, understanding, assessment and proper management. What could be the reason as by its name and diagnostic criteria an etiological fact is specified, namely a specific traumatic event. In our paper we aim to share and elicit some difficulties that we have met in consulting, diagnostic and management of people, who have suffered a traumatic event. On the base of a review of current psychiatric classifications and ongoing discussions we briefly summarize and discuss important key points. The definition of the event, associated with PTSD is different in DSM-III (introduced for the fist time in a classification of mental disorders, DSM-IV and ICD-10. DSM-IV is less restrictive and includes events that occur more frequently. In DSM-5, PTSD is placed in chapter “Trauma and Stressor-related disorders” and the accent is on the variable clinical characteristics of psychological distress. Emotional reactions to the traumatic event are no longer part of Criterion A. The clinical presentation varies and a number of intrusive psychological and physiological reactions of distress are described. Here comes a problem- the assessment of the trauma itself and the determination of the basic symptoms, when such an event happens. So, the skills to assess the trauma, to determine and competently attribute these symptoms to the specific event and cluster are of great importance. We conclude that a number of risk and prognostic factors should be considered in the process of assessment, diagnosis and management.

  12. Posttraumatic stress in emergency settings outside North America and Europe: a review of the emic literature.

    Science.gov (United States)

    Rasmussen, Andrew; Keatley, Eva; Joscelyne, Amy

    2014-05-01

    Mental health professionals from North America and Europe have become common participants in postconflict and disaster relief efforts outside of North America and Europe. Consistent with their training, these practitioners focus primarily on posttraumatic stress disorder (PTSD) as their primary diagnostic concern. Most research that has accompanied humanitarian aid efforts has likewise originated in North America and Europe, has focused on PTSD, and in turn has reinforced practitioners' assumptions about the universality of the diagnosis. In contrast, studies that have attempted to identify how local populations conceptualize posttrauma reactions portray a wide range of psychological states. We review this emic literature in order to examine differences and commonalities across local posttraumatic cultural concepts of distress (CCDs). We focus on symptoms to describe these constructs - i.e., using the dominant neo-Kraepelinian approach used in North American and European psychiatry - as opposed to focusing on explanatory models in order to examine whether positive comparisons of PTSD to CCDs meet criteria for face validity. Hierarchical clustering (Ward's method) of symptoms within CCDs provides a portrait of the emic literature characterized by traumatic multifinality with several common themes. Global variety within the literature suggests that few disaster-affected populations have mental health nosologies that include PTSD-like syndromes. One reason for this seems to be the almost complete absence of avoidance as pathology. Many nosologies contain depression-like disorders. Relief efforts would benefit from mental health practitioners getting specific training in culture-bound posttrauma constructs when entering settings beyond the boundaries of the culture of their training and practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. A model linking uncertainty, post-traumatic stress, and health behaviors in childhood cancer survivors.

    Science.gov (United States)

    Lee, Ya-Ling; Gau, Bih-Shya; Hsu, Wen-Ming; Chang, Hsiu-Hao

    2009-01-01

    To consolidate the literature and provide a model to explain the links among uncertainty, post-traumatic stress syndrome, and health behaviors in adolescent and young adult childhood cancer survivors. A systemic review of related literature and theory was used for the proposed model. The literature pertaining to the Uncertainty in Illness Theory, childhood cancer late effects, post-traumatic stress, and health behaviors was reviewed and critiqued from three data sets from 1979-2007: MEDLINE, PsycInfo, and CINAHL. Key words used for the search were uncertainty and post-traumatic stress as well as health behaviors, including smoking, alcohol use, unsafe sex, sunscreen use, and physical inactivity. Childhood cancer survivors living with chronic uncertainty may develop a new view of life and, as a result, adopt more health-promotion behaviors and engage in less health-risk behaviors. However, survivors living with chronic uncertainty may generate symptoms similar to post-traumatic stress disorder and, therefore, adopt fewer health-promotion behaviors and engage in more health-risk behaviors. The uncertainty that pervades the childhood cancer experience can lead to the development of symptoms that resemble those of post-traumatic stress. The symptoms can interfere with the adoption of healthy lifestyle behaviors and avoidance of health-risk behaviors. The theoretically derived model outlined in this article can be used to guide clinical interventions and additional research into the health behaviors of childhood cancer survivors.

  14. Pharmacotherapy of post-traumatic stress disorder: a family practitioners guide to management of the disease.

    Science.gov (United States)

    Katzman, Martin A; Struzik, Lukasz; Vivian, Lisa L; Vermani, Monica; McBride, Joanna C

    2005-01-01

    Post-traumatic stress disorder is a difficult to treat, yet common disorder, which is associated with significant morbidity, mortality and societal burden. Comprehensive management of post-traumatic stress disorder must include both psychotherapeutic and pharmacologic components. The current evidence-based pharmacologic management approaches to post-traumatic stress disorder, suggests that first-line treatments for monotherapy are the selective serotonin reuptake inhibitors, sertraline, paroxetine and fluoxetine. Other potential options include other monotherapies including venlafaxine, mirtazapine, tricyclic antidepressants, monoamine oxidase inhibitors, as well as adjunctive usage of atypical antipsychotics, lamotrigine, trazadone and a number of adrenergic agents. A trial of therapy should be at least 8 weeks and continue for at the very least 12 months, but is likely to be much longer. In light of the risks of untreated post-traumatic stress disorder (e.g., suicide and impaired psychosocial functioning), therapy may need to be continued for 2 years or more. Pharmacologic therapy instituted at the time of acute psychologic trauma shows promise for the prevention of post-traumatic stress disorder in the future and warrants further study.

  15. Post-traumatic Stress Symptoms among Iranian Parents of Children during Cancer Treatment.

    Science.gov (United States)

    Iranmanesh, Sedigheh; Shamsi, Ala; Dehghan, Mahlegha

    2015-04-01

    Support of parents of children with cancer requires healthcare personnel to be knowledgeable about the prevalence of post-traumatic stress symptoms among Iranian parents of children with cancer. This study was conducted to fulfill this aim in the South-East of Iran. Using the Impact of Event Scale -Revised, for parents of children with cancer, 200 parents in two hospitals supervised by Kerman University of Medical Sciences, were assessed. The total mean score of post-traumatic stress symptoms was 41.70. Among all categories of the Impact of Event Scale -Revised, the highest mean belonged to the category of 'intrusion' 16.03 (SD  =  6.24) and the lowest one belonged to the category of 'hyperarousal' 10.68 (SD  =  4.58). Based on the results, mothers had higher post-traumatic stress symptoms compared with fathers (p post-traumatic stress symptoms among mothers was 2.49 times more than that among fathers (p  =  0.01). There was no association between sociodemographic data and post-traumatic stress symptoms. More research is needed to elucidate the Iranian parents' experience of having children with cancer.

  16. Smaller hippocampal volume as a vulnerability factor for the persistence of post-traumatic stress disorder

    NARCIS (Netherlands)

    van Rooij, S J H; Kennis, M; Sjouwerman, R; van den Heuvel, M P; Kahn, R S; Geuze, E

    2015-01-01

    BACKGROUND: Smaller hippocampal volume has often been observed in patients with post-traumatic stress disorder (PTSD). However, there is no consensus whether this is a result of stress/trauma exposure, or constitutes a vulnerability factor for the development of PTSD. Second, it is unclear whether h

  17. Smaller hippocampal volume as a vulnerability factor for the persistence of post-traumatic stress disorder

    NARCIS (Netherlands)

    Van Rooij, S. J H; Kennis, M.; Sjouwerman, R.; Van Den Heuvel, M. P.|info:eu-repo/dai/nl/304820466; Kahn, R. S.|info:eu-repo/dai/nl/073778532; Geuze, E.

    2015-01-01

    Background Smaller hippocampal volume has often been observed in patients with post-traumatic stress disorder (PTSD). However, there is no consensus whether this is a result of stress/trauma exposure, or constitutes a vulnerability factor for the development of PTSD. Second, it is unclear whether hi

  18. Prevention and Treatment of Posttraumatic Stress Disorder in the School Setting

    Science.gov (United States)

    Kruczek, Theresa; Salsman, Jill

    2006-01-01

    Trauma has the potential to undermine both the educational and personal achievement of students. This article will provide a review and an integration of theoretical and empirical literature on the prevention and treatment of stress disorders, particularly posttraumatic stress disorder (PTSD) in children and teens. An initial review of the…

  19. Postdeployment Symptom Changes and Traumatic Brain Injury and/or Posttraumatic Stress Disorder in Men

    Science.gov (United States)

    2012-01-01

    traumatic brain injury ( TBI ) and posttraumatic stress disorder...stress disorder, TBI = traumatic brain injury . *Address all correspondence to Hilary J. Aralis, MS; Naval Health Research Center, Warfighter...both diagnoses. See Figure 1 for sampling details. Figure 1. Flow diagram outlining selection of final blast traumatic brain injury ( TBI ) and no TBI

  20. Perceived Racial/Ethnic Discrimination, Posttraumatic Stress Symptoms, and Health Risk Behaviors among Mexican American Adolescents

    Science.gov (United States)

    Flores, Elena; Tschann, Jeanne M.; Dimas, Juanita M.; Pasch, Lauri A.; de Groat, Cynthia L.

    2010-01-01

    Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California.…

  1. Simple and Complex Post-Traumatic Stress Disorder: Strategies for Comprehensive Treatment in Clinical Practice.

    Science.gov (United States)

    Williams, Mary Beth; Sommer, John F., Jr.

    This book delivers state-of-the-art techniques and information for practitioners to help individuals, groups, families, and communities suffering from post-traumatic stress disorder (PTSD). It addresses concerns about the efficacy of critical incident stress debriefing, examines the value of a variety of innovative treatment methods, and explores…

  2. Complex Posttraumatic Stress Disorder in Patients with Borderline Personality Disorder and Somatoform Disorders

    NARCIS (Netherlands)

    van Dijke, A.; Ford, J.D.; Van der Hart, O.; Van Son, M.J.M.; Van der Heijden, P.G.M.; Buerhing, M.

    2012-01-01

    Disorders of Extreme Stress Not Otherwise Specified (DESNOS), also known as Complex posttraumatic stress disorder, was assessed in a sample (N = 472) of adult psychiatric patients with confirmed diagnoses of Borderline Personality Disorder (BPD), Somatoform Disorders (SoD), comorbid BPD + SoD, or Af

  3. Posttraumatic Stress Disorder and Intimate Relationship Problems: A Meta-Analysis

    Science.gov (United States)

    Taft, Casey T.; Watkins, Laura E.; Stafford, Jane; Street, Amy E.; Monson, Candice M.

    2011-01-01

    Objective: The authors conducted a meta-analysis of empirical studies investigating associations between indices of posttraumatic stress disorder (PTSD) and intimate relationship problems to empirically synthesize this literature. Method: A literature search using PsycINFO, Medline, Published International Literature on Traumatic Stress (PILOTS),…

  4. Bridging the Gap between Posttraumatic Stress Disorder and the Learning Process: A Phenomenological Study

    Science.gov (United States)

    Phillips, Charlotte A.

    2011-01-01

    Posttraumatic stress disorder (PTSD) affects the learning process for adult learners, resulting in a higher dropout rate than for students who have not experienced similar stress (Kerka, 2002; Smyth, Hockemeyer, Heron, Wonderlich, & Pennebaker, 2008). The purpose of the current qualitative phenomenological study was to identify, explore, and…

  5. A community-based survey of posttraumatic stress disorder in the Netherlands

    NARCIS (Netherlands)

    Bronner, M.B.; Peek, N.; de Vries, M.; Bronner, A.E.; Last, B.F.; Grootenhuis, M.A.

    2009-01-01

    In this study, the lifetime prevalence of stressful events and current posttraumatic stress disorder (PTSD) in the general adult population in theNetherlands were examined, and risk groups for PTSD were determined. A representative sample of 2,238 adults (≥18 years) in the Netherlands completed digi

  6. Posttraumatic Stress in U.S. Marines: The Role of Unit Cohesion and Combat Exposure

    Science.gov (United States)

    Armistead-Jehle, Patrick; Johnston, Scott L.; Wade, Nathaniel G.; Ecklund, Christofer J.

    2011-01-01

    Combat exposure is a consistent predictor of posttraumatic stress (PTS). Understanding factors that might buffer the effects of combat exposure is crucial for helping service members weather the stress of war. In a study of U.S. Marines returning from Iraq, hierarchical multiple regression analyses revealed that unit cohesion and combat exposure…

  7. From Soldiers to Children: Developmental Sciences Transform the Construct of Posttraumatic Stress Disorder

    Science.gov (United States)

    Franks, Bridget A.

    2014-01-01

    Posttraumatic stress disorder (PTSD) was first included in the American Psychiatric Association's "Diagnostic and statistical manual of mental disorders" in 1980. Long used to describe the reactions of soldiers affected by stress in combat situations, PTSD is now recognised as a disorder affecting abused and neglected infants and…

  8. Perceived Racial/Ethnic Discrimination, Posttraumatic Stress Symptoms, and Health Risk Behaviors among Mexican American Adolescents

    Science.gov (United States)

    Flores, Elena; Tschann, Jeanne M.; Dimas, Juanita M.; Pasch, Lauri A.; de Groat, Cynthia L.

    2010-01-01

    Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California.…

  9. Together in Pain: Attachment-Related Dyadic Processes and Posttraumatic Stress Disorder

    Science.gov (United States)

    Ein-Dor, Tsachi; Doron, Guy; Solomon, Zahava; Mikulincer, Mario; Shaver, Phillip R.

    2010-01-01

    We used actor-partner interdependence modeling to explore associations among attachment-related dyadic processes, posttraumatic stress disorder (PTSD) in war veterans, and secondary traumatic stress (STS) in their wives. A sample of 157 Israeli couples (85 former prisoners of war and their wives and a comparison group of 72 veterans not held…

  10. Adult Neurogenesis, Chronic Stress and Depression

    NARCIS (Netherlands)

    Lucassen, P.J.; Oomen, C.A.; Schouten, M.; Encinas, J.M.; Fitzsimons, C.P.; Canales, J.J.

    2016-01-01

    A major risk factor for depression in vulnerable individuals is exposure to stress during critical periods. Stress affects mood and cognition and is also one of the best known inhibitors of adult neurogenesis that has been associated with hippocampal changes and atrophy, common findings in major dep

  11. Adult Neurogenesis, Chronic Stress and Depression

    NARCIS (Netherlands)

    Lucassen, P.J.; Oomen, C.A.; Schouten, M.; Encinas, J.M.; Fitzsimons, C.P.; Canales, J.J.

    2016-01-01

    A major risk factor for depression in vulnerable individuals is exposure to stress during critical periods. Stress affects mood and cognition and is also one of the best known inhibitors of adult neurogenesis that has been associated with hippocampal changes and atrophy, common findings in major

  12. The structure of post-traumatic stress disorder and complex post-traumatic stress disorder amongst West Papuan refugees.

    Science.gov (United States)

    Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Silove, Derrick

    2015-05-07

    The validity of applying the construct of post-traumatic stress disorder (PTSD) across cultures has been the subject of contention. Although PTSD symptoms have been identified across multiple cultures, questions remain whether the constellation represents a coherent construct with an interpretable factor structure across diverse populations, especially those naïve to western notions of mental disorder. An important additional question is whether a constellation of Complex-PTSD (C-PTSD) can be identified and if so, whether there are distinctions between that disorder and core PTSD in patterns of antecedent traumatic events. Our study amongst West Papuan refugees in Papua New Guinea (PNG) aimed to examine the factorial structure of PTSD based on the DSM-IV, DSM-5, ICD-10 and ICD-11 definitions, and C-PTSD according to proposed ICD-11 criteria. We also investigated domains of traumatic events (TEs) and broader psychosocial effects of conflict (sense of safety and injustice) associated with the factorial structures identified. Culturally adapted measures were applied to assess exposure to conflict-related traumatic events (TEs), refugees' sense of safety and justice, and symptoms of PTSD and C-PTSD amongst 230 West Papuan refugees residing in Port Morseby, PNG. Confirmatory factor analysis (CFA) supported a unitary construct of both ICD-10 and ICD-11 PTSD, comprising the conventional symptom subdomains of intrusion, avoidance, and hyperarousal. In contrast, CFA did not identify a unitary construct underlying C-PTSD. The interaction of witnessing murders and sense of injustice was associated with both the intrusion and avoidance domains of PTSD, but not with the unique symptom clusters characterizing C-PTSD. Our findings support the ICD PTSD construct and its three-factor structure in this transcultural refugee population. Traumatic experiences of witnessing murder associated with a sense of injustice were specifically related to the intrusion and avoidance domains of

  13. Post-traumatic stress disorder among people exposed to the Ventotene street disaster in Rome

    Directory of Open Access Journals (Sweden)

    Onofri Antonio

    2008-03-01

    Full Text Available Abstract Objective To test five hypotheses on Post-traumatic stress disorder (PTSD: 1 Is PTSD the most prevalent disorder after trauma? 2 Is the proximity to the disaster related to the risk of PTSD? 3 Is PTSD associated with child mourning or separation, previous stress, or familiarity for psychiatric disorders? 4 Does the exposition to trauma increase substance abuse or somatization? 5 Can episodic trauma cause long-lasting psychiatric morbidity? Methods Clinical assessment of subjects exposed to an explosion in a building caused by a gas-leak. Best estimate clinical diagnoses were made according to DSM-IV-TR criteria. The Zung Depression Rating Scale, the Zung Anxiety Rating Scale, and the Clinician Administered Post Traumatic Stress Disorder Scale were used in the clinical assessment. Statistical analysis was performed by means of t-test with Bonferroni's correction on continuous variables and χ2 or Fisher test on categorical variables. Results PTSD was the most prevalent disorder after trauma, diagnosed in 32 (36.8% subjects. The subjects who had not seen dead or injured people were more likely to receive no psychiatric diagnosis. Civil status, parenthood, death of relatives in the disaster, personal injuries, history of child mourning or separation, of previous stress, as well as familiarity for any psychiatric disorder or substance use disorder were not related with the rate of ascertained psychiatric diagnoses. Nearly two years after trauma, most of patients who had suffered PTSD still met PTSD criteria. Conclusion The 1st and the 5th hypotheses were corroborated, the 3rd and the 4th hypotheses were not confirmed. The 2nd hypothesis was partially confirmed.

  14. Trauma and post-traumatic stress symptoms in former German child soldiers of World War II.

    Science.gov (United States)

    Kuwert, Philipp; Spitzer, Carsten; Rosenthal, Jenny; Freyberger, Harald J

    2008-10-01

    The aim of the study was to determine the amount of trauma impact and significant post-traumatic stress symptoms, which can indicate a possible post-traumatic stress disorder (PTSD), in a sample of former German child soldiers of World War II. 103 participants were recruited through the press, then administered a modified Post-traumatic Diagnostic Scale (PDS). Subjects reported a high degree of trauma exposure, with 4.9% reporting significant post-traumatic stress symptoms after WW II, and 1.9% reporting that these symptoms persist to the present. In line with other studies on child soldiers in actual conflict settings, our data document a high degree of trauma exposure during war. Surprisingly, the prevalence of significant post-traumatic stress symptoms indicating a possible PTSD was low compared to other groups of aging, long-term survivors of war trauma. Despite some limitations our data highlight the need for further studies to identify resilience and coping factors in traumatized child soldiers.

  15. Occupational stress and depression in Korean employees.

    Science.gov (United States)

    Cho, Jung Jin; Kim, Ji Yong; Chang, Sei Jin; Fiedler, Nancy; Koh, Sang Baek; Crabtree, Benjamin F; Kang, Dong Mug; Kim, Yong Kyu; Choi, Young Ho

    2008-10-01

    The purpose of this study is to analyze what aspects of occupational stress predict depression among Korean workers, and determine which components of occupational stress or job characteristics is more strongly associated with depression. In this cross-sectional study, a total of 8,522 workers (21-65 years of age) from a nationwide sample were recruited. A self-administered questionnaire was used to assess socio-demographics, job characteristics, depressive symptoms measured by the Center for Epidemiologic Studies Depression Scale, and occupational stress assessed by the Korean occupational stress scale (KOSS). Multivariate analyses show that inadequate social support (OR = 1.58, 95% CI = 1.52, 1.66) and discomfort in occupational climate (OR = 1.25, 95% CI = 1.18, 1.32) were more important risk factors for depression than organizational injustice, job demand and job control. Compared to the 'business activities' industries, 'recreational, cultural and sporting activities' (OR = 3.45, 95% CI = 1.80, 6.58), 'hotel and restaurants' (OR = 3.34, 95% CI = 1.92, 5.80), 'real estate and renting and leasing' (OR = 2.24, 95% CI = 1.13, 4.44), 'wholesale and retail' (OR = 1.85, 95% CI = 1.28, 2.67), 'transportation' (OR = 1.85, 95% CI = 1.11, 3.07), and 'financial institute and insurance' (OR = 1.60, 95% CI = 1.04, 2.48) industries had significantly greater risk of depression after controlling for gender, age, marital status, duration of employment and all subscale of KOSS. The finding that inadequate social support and discomfort in occupational climate is a better predictor of depressive symptoms than organizational injustice in Korea, indicates that the newly developed KOSS has cultural relevance for assessing occupational stress in Korea. Future studies need to understand factors such as "emotional labor" within certain industries where increased risk for depression is observed.

  16. Effectiveness of Cognitive Behavioral Group Therapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Seda Tokgunaydin

    2016-03-01

    Full Text Available This study aims to review empirical studies that were used to evaluate the effectiveness of cognitive-behavioral group therapy programs for the treatment for posttraumatic stress disorder. Articles in English and Turkish that were published between the years of 2000 and 2015 (February have been searched in national and international databases. The articles that were gathered by the search have been read and the ones that were not therapy effectiveness studies, cognitive behavioral group therapies and that included posttraumatic stress disorder comorbid with alcohol/substance abuse, personality disorders and psychotic disorders were eliminated. The remaining 13 studies that fulfiilrf research criteria were introduced in the context of method and therapy characteristics. It can be seen that the cognitive behavioral group therapies are effective in decreasing the symptoms of posttraumatic stress disorder and/or comorbid disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(Supplement 1: 95-107

  17. Psychoneuroendocrinological studies on chronic stress and depression.

    Science.gov (United States)

    Tafet, Gustavo E; Smolovich, Jaime

    2004-12-01

    The adaptive response to stress is characterized by activation of neural and neuroendocrine cascades mediated mainly by the noradrenergic/sympathetic and limbic-hypothalamic-pituitary-adrenal (HPA) systems, respectively. Chronic psychosocial stress has long been associated with the origin and development of depression, where increased levels of cortisol have been observed in both conditions. In this regard, increased levels of cortisol could be directly involved in the mood changes observed in depression, and direct connections between these and alterations of the serotonergic neurotransmission have been also proposed. Therefore, we investigated the potential link between alterations of the limbic-HPA system with the serotonergic hypothesis of depression at both the molecular and clinical levels. Our findings support the notion that chronic psychosocial stress may lead to depression in certain individuals depending on the psychobiological background and their particular psychological resources. Therefore, certain interventions aimed at normalization of the HPA system could potentially prevent the development of depression in chronically stressed subjects. This would be possible through either pharmacological interventions or psychotherapeutic strategies, such as cognitive therapy, aimed at improving resilience and controllability in stressful situations.

  18. Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief

    Institute of Scientific and Technical Information of China (English)

    Junhua Huang; Qunying Liu; Jinliang Li; Xuejiang Li; Jin You; Liang Zhang; Changfu Tian; Rongsheng Luan

    2013-01-01

    Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12th, 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate sta-tistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in mul-tivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the oc-currence of post-traumatic stress disorder was the result of the interaction of multiple factors.

  19. Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief.

    Science.gov (United States)

    Huang, Junhua; Liu, Qunying; Li, Jinliang; Li, Xuejiang; You, Jin; Zhang, Liang; Tian, Changfu; Luan, Rongsheng

    2013-07-15

    Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12(th), 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate statistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in multivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the occurrence of post-traumatic stress disorder was the result of the interaction of multiple factors.

  20. Discriminating Malingered from Genuine Civilian Posttraumatic Stress Disorder: A Validation of Three MMPI-2 Infrequency Scales (F, Fp, and Fptsd)

    Science.gov (United States)

    Elhai, Jon D.; Naifeh, James A.; Zucker, Irene S.; Gold, Steven N.; Deitsch, Sarah E.; Frueh, B. Christopher

    2004-01-01

    The Infrequency-Posttraumatic Stress Disorder scale (Fptsd), recently created for the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), has demonstrated incremental validity over other MMPI-2 scales in malingered posttraumatic stress disorder (PTSD) detection. Fptsd was developed with combat-exposed PTSD patients, potentially limiting its…

  1. Brief Report: The Relationship between Post-Traumatic Stress Disorder Symptoms and Overgeneral Autobiographical Memory in Older Adults

    Science.gov (United States)

    Robinson, Sarah R.; Jobson, Laura A.

    2013-01-01

    Objective: The aim of this study was to investigate the relationship between post-traumatic stress disorder (PTSD) symptoms and autobiographical memory specificity in older adults. Method: Older adult trauma survivors (N = 23) completed the Autobiographical Memory Test, Posttraumatic Stress Diagnostic Scale, and Addenbrooke's Cognitive…

  2. Validation of the Primary Care Posttraumatic Stress Disorder screening questionnaire (PC-PTSD) in civilian substance use disorder patients

    NARCIS (Netherlands)

    D. van Dam; T. Ehring; E. Vedel; P.M.G. Emmelkamp

    2010-01-01

    This study aimed to cross-validate and extend earlier findings regarding the diagnostic efficiency of the four-item Primary Care Posttraumatic Stress Disorder Screen (PC-PTSD) as a screening questionnaire for posttraumatic stress disorder (PTSD) among civilian patients with substance use disorder (S

  3. Brief Report: The Relationship between Post-Traumatic Stress Disorder Symptoms and Overgeneral Autobiographical Memory in Older Adults

    Science.gov (United States)

    Robinson, Sarah R.; Jobson, Laura A.

    2013-01-01

    Objective: The aim of this study was to investigate the relationship between post-traumatic stress disorder (PTSD) symptoms and autobiographical memory specificity in older adults. Method: Older adult trauma survivors (N = 23) completed the Autobiographical Memory Test, Posttraumatic Stress Diagnostic Scale, and Addenbrooke's Cognitive…

  4. The Utility of the Personality Assessment Inventory in the Assessment of Posttraumatic Stress Disorder in OEF/OIF/OND Veterans.

    Science.gov (United States)

    Bellet, Benjamin W; McDevitt-Murphy, Meghan E; Thomas, Danielle H; Luciano, Matthew T

    2017-01-01

    We examined the use of the Personality Assessment Inventory (PAI) in a small sample of 47 U.S. military veterans of the conflicts in Iraq and Afghanistan. Approximately half of the sample met criteria for posttraumatic stress disorder (PTSD) based on the Clinician-Administered PTSD Scale. PAI profiles were compared between the PTSD and non-PTSD groups. The PTSD group had clinically significant scores (≥ 70 T) on the PAI for 5 clinical scales (anxiety, anxiety-related disorders, depression, paranoia, and schizophrenia) and 10 clinical subscales consistent with the typical symptom picture for PTSD. Effect size correlations ( r) between scales and diagnosis group membership were large ( r ≥ .5) for several scales that reflect PTSD symptoms and for the PTSD LOGIT function. In a receiver operating characteristics curve analysis, the PTSD LOGIT function and the Traumatic Stress Subscale both demonstrated good diagnostic utility (areas under the curve > .80).

  5. Virtual reality exposure therapy for post-traumatic stress disorder and other anxiety disorders.

    Science.gov (United States)

    Gerardi, Maryrose; Cukor, Judith; Difede, Joann; Rizzo, Albert; Rothbaum, Barbara Olasov

    2010-08-01

    Anxiety disorders, including phobias and post-traumatic stress disorder, are common and disabling disorders that often involve avoidance behavior. Cognitive-behavioral treatments, specifically imaginal and in vivo forms of exposure therapy, have been accepted and successful forms of treatment for these disorders. Virtual reality exposure therapy, an alternative to more traditional exposure-based therapies, involves immersion in a computer-generated virtual environment that minimizes avoidance and facilitates emotional processing. In this article, we review evidence on the application of virtual reality exposure therapy to the treatment of specific phobias and post-traumatic stress disorder and discuss its advantages and cautions.

  6. Assessing the specificity of posttraumatic stress disorder's dysphoric items within the dysphoria model

    DEFF Research Database (Denmark)

    Armour, C.; Shevlin, M.

    2013-01-01

    The factor structure of posttraumatic stress disorder (PTSD) currently used by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), has received limited support. A four-factor dysphoria model is widely supported. However, the dysphoria factor of this model has been ...... in the upcoming DSM-5.......The factor structure of posttraumatic stress disorder (PTSD) currently used by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), has received limited support. A four-factor dysphoria model is widely supported. However, the dysphoria factor of this model has been...

  7. An Alternative Approach to the Effects of Multiple Traumas: Complex Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Taycan, Okan; Yildirim, Ahmet

    2015-09-01

    Exposure to multiple traumatic events, particularly in childhood, has been shown to result in more complex symptoms than those seen after exposure to a single traumatic event. In case of overlooking the link between trauma and psychopathology, patients with multiple traumatic experiences receive a variety of different diagnoses that are unable to completely cover the clinical picture. Misdiagnoses of genuine cases inevitably lead to mistreatment. A diagnosis of complex post-traumatic stress disorder has been proposed to cover the emerging psychopathology in survivors of multiple traumas. This present report aimed to discuss the construct and to increase the awareness of complex post-traumatic stress disorder diagnosis among mental health professionals.

  8. Posttraumatic stress disorder among Danish soldiers 2.5 years after military deployment in Afghanistan

    DEFF Research Database (Denmark)

    Hellerup, Janne; Andersen, Søren Bo; Høgh (Hogh), Annie

    2015-01-01

    Understanding the development of posttraumatic stress disorder (PTSD) implicates research regarding factors besides the preceding traumatic event. This study investigated the influence of predisposing personality traits on development of PTSD in a group of Danish Soldiers deployed to Afghanistan (N...... = 445). Using a prospective design data was collected using questionnaires including the NEO Five Factor Inventory and the Posttraumatic Stress Disorder Checklist. The results showed a PTSD-prevalence of 9.2% in the total sample 2.5 years after homecoming. Using Kruskal-Wallis, Mann-Whitney U...

  9. Developing a Symptom Validity Test for posttraumatic stress disorder: application of the binomial distribution.

    Science.gov (United States)

    Morel, Kenneth R; Shepherd, Bryan E

    2008-12-01

    The past decade has witnessed a significant increase in research on the detection of malingered Posttraumatic Stress Disorder (PTSD) in civil litigation, other disability pension contexts, and in forensic cases. This article reviews the basic principles and statistical procedures that can be used to design and develop a Symptom Validity Test (SVT) for PTSD. We demonstrate how the practical application of the binomial distribution can detect response bias in specific psychiatric disorders such as PTSD and can provide empirically grounded probabilistic evidence of malingering. We cite the Morel Emotional Numbing Test for Posttraumatic Stress Disorder (MENT) as an example.

  10. Posttraumatic stress symptoms in breast cancer: Prevalence, predictors, consequences, and treatment

    DEFF Research Database (Denmark)

    O Connor, Maja; Zachariae, Robert

    2015-01-01

    This chapter focuses on posttraumatic stress reactions after being diagnosed with and treated for breast cancer. Posttraumatic stress symptoms (PTSS) are evident in a significant proportion of women after having experienced diagnosis and treatment of breast cancer. Several risk factors...... for developing long-term PTSS after breast cancer have been identified. Younger age, low education and income, pre-cancer previous psychiatric history, cancer disease severity, poor physical functioning, and acute symptoms of PTSS are predictors of long-term post-cancer PTSS, with poor physical functioning...

  11. Incidence of posttraumatic stress disorder after traffic accidents in Germany.

    Science.gov (United States)

    Brand, Stephan; Otte, Dietmar; Petri, Maximilian; Decker, Sebastian; Stübig, Timo; Krettek, Christian; Müller, Christian W

    2014-01-01

    Posttraumatic stress disorder (PTSD) is possibly an overlooked diagnosis of victims suffering from traffic accidents sustaining serious to severe injuries. This paper investigates the incidence of PTSD after traffic accidents in Germany. Data from an accident research unit were analyzed in regard to collision details, and preclinical and clinical data. Preclinical data included details on crash circumstances and estimated injury severity as well as data on victims' conditions (e.g. heart rate, blood pressure, consciousness, breath rate). Clinical data included initial assessment in the emergency department, radiographic diagnoses, and basic life parameters comparable to the preclinical data as well as follow-up data on the daily ward. Data were collected in the German-In-Depth Accident Research study, and included gender, type of accident (e.g. type of vehicle, road conditions, rural or urban area), mental disorder, and AIS (Abbreviated Injury Scale) head score. AIS represent a scoring system to measure the injury severity of traffic accident victims. A total 258 out of 32807 data sets were included in this analysis. Data on accident and victims was collected on scene by specialized teams following established algorithms. Besides higher AIS Head scores for male motorcyclists compared to all other subgroups, no significant correlation was found between the mean maximum AIS score and the occurrence of PTSD. Furthermore, there was no correlation between higher AIS head scores, gender, or involvement in road traffic accidents and PTSD. In our study the overall incidence of PTSD after road traffic accidents was very low (0.78% in a total of 32.807 collected data sets) when compared to other published studies. The reason for this very low incidence of PTSD in our patient sample could be seen in an underestimation of the psychophysiological impact of traffic accidents on patients. Patients suffering from direct experiences of traumatic events such as a traffic accident

  12. Prediction of posttraumatic stress disorder among adults in flood district

    Directory of Open Access Journals (Sweden)

    Feng Shuidong

    2010-04-01

    Full Text Available Abstract Background Flood is one of the most common and severe forms of natural disasters. Posttraumatic stress disorder (PTSD is a common disorder among victims of various disasters including flood. Early prediction for PTSD could benefit the prevention and treatment of PTSD. This study aimed to establish a prediction model for the occurrence of PTSD among adults in flood districts. Methods A cross-sectional survey was carried out in 2000 among individuals who were affected by the 1998 floods in Hunan, China. Multi-stage sampling was used to select subjects from the flood-affected areas. Data was collected through face-to-face interviews using a questionnaire. PTSD was diagnosed according to DSM-IV criteria. Study subjects were randomly divided into two groups: group 1 was used to establish the prediction model and group 2 was used to validate the model. We first used the logistic regression analysis to select predictive variables and then established a risk score predictive model. The validity of model was evaluated by using the model in group 2 and in all subjects. The area under the receiver operation characteristic (ROC curve was calculated to evaluate the accuracy of the prediction model. Results A total of 2336 (9.2% subjects were diagnosed as probable PTSD-positive individuals among a total of 25,478 study subjects. Seven independent predictive factors (age, gender, education, type of flood, severity of flood, flood experience, and the mental status before flood were identified as key variables in a risk score model. The area under the ROC curve for the model was 0.853 in the validation data. The sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV of this risk score model were 84.0%, 72.2%, 23.4%, and 97.8%, respectively, at a cut-off value of 67.5 in the validation data. Conclusions A simple risk score model can be used to predict PTSD among victims of flood.

  13. A model of suicidal behavior in posttraumatic stress disorder (PTSD): the mediating role of defeat and entrapment.

    Science.gov (United States)

    Panagioti, Maria; Gooding, Patricia; Taylor, Peter James; Tarrier, Nicholas

    2013-08-30

    The aim of this study was to examine whether depression, hopelessness and perceptions of defeat and entrapment mediated the effects of posttraumatic stress disorder (PTSD) symptoms on suicidal behavior. Participants were 73 individuals (mean age=29.2, S.D.=10.9, 79.5% female) diagnosed with current or lifetime PTSD who reported at least one PTSD symptom in the past month. Participants completed a series of self-report measures assessing depression, hopelessness and perceptions of defeat and entrapment. The Clinician Administrated Posttraumatic Scale for DSM-IV was administered to assess the presence and severity of PTSD symptoms. The results of Structural Equation Modeling supported a model whereby perceptions of defeat and entrapment fully mediated the effects of PTSD symptom severity upon suicidal behavior. The finding that perceptions of defeat and entrapment mediate the relationship between PTSD symptom severity and suicidal behavior was replicated in a subgroup of participants (n=50) who met the full criteria for a current PTSD diagnosis. The results support a recent theoretical model of suicide (The Schematic Appraisal Model of Suicide) which argues that perceptions of defeat and entrapment have a key role in the development of suicidal behaviors. We discuss the clinical implications of the findings.

  14. Negative Social Relationships Predict Posttraumatic Stress Symptoms Among War-Affected Children Via Posttraumatic Cognitions.

    Science.gov (United States)

    Palosaari, Esa; Punamäki, Raija-Leena; Peltonen, Kirsi; Diab, Marwan; Qouta, Samir R

    2016-07-01

    Post traumatic cognitions (PTCs) are important determinants of post traumatic stress symptoms (PTS symptoms). We tested whether risk factors of PTS symptoms (trauma, demographics, social and family-related factors) predict PTCs and whether PTCs mediate the association between risk factors and PTS symptoms among war-affected children. The participants were 240 Palestinian children 10-12 years old, half boys and half girls, and their parents. Children reported about psychological maltreatment, sibling and peer relations, war trauma, PTCs, PTS symptoms, and depression. Parents reported about their socioeconomic status and their own PTS symptoms. The associations between the variables were estimated in structural equation models. In models which included all the variables, PTCs were predicted by and mediated the effects of psychological maltreatment, war trauma, sibling conflict, and peer unpopularity on PTS symptoms. Other predictors had statistically non-significant effects. Psychological maltreatment had the largest indirect effect (b* = 0.29, p = 0.002) and the indirect effects of war trauma (b* = 0.10, p = 0.045), sibling conflict (b* = 0.10, p = 0.045), and peer unpopularity (b* = 0.10, p = 0.094) were lower and about the same size. Age-salient social relationships are potentially important in the development of both PTCs and PTS symptoms among preadolescents. Furthermore, PTCs mediate the effects of the risk factors of PTS symptoms. The causality of the associations among the variables is not established but it could be studied in the future with interventions which improve the negative aspects of traumatized children's important social relationships.

  15. Associations of Childhood Trauma, Trauma in Adulthood and Previous-Year Stress with Psychopathology in Patients with Major Depression and Borderline Personality Disorder

    Science.gov (United States)

    Wingenfeld, Katja; Schaffrath, Camille; Rullkoetter, Nina; Mensebach, Christoph; Schlosser, Nicole; Beblo, Thomas; Driessen, Martin; Meyer, Bjorn

    2011-01-01

    Posttraumatic stress disorder (PTSD) is an important possible outcome of exposure to traumatic events that occur in childhood. However, early traumatic experiences are also an important risk factor for several other mental disorders, such as borderline personality disorder and major depressive disorder. Furthermore, chronic stress, including daily…

  16. Gender-specific predictors of posttraumatic stress disorder in adolescents

    DEFF Research Database (Denmark)

    Donbaek, Dagmar Feddern; Elklit, Ask

    2015-01-01

    that drug abuse and avoidant attachment to best friends were significant predictors of PTSD severity in male adolescents, whereas alcohol abuse and the absence of posttraumatic social support from parents remained significant predictors for female adolescents. The results support the influence of gender......-specific substance abuse patterns and dysfunctional interpersonal relationships on the PTSD severity of traumatized adolescents....

  17. Autobiographical integration of trauma memories and repressive coping predict post-traumatic stress symptoms in undergraduate students.

    Science.gov (United States)

    Smeets, Tom; Giesbrecht, Timo; Raymaekers, Linsey; Shaw, Julia; Merckelbach, Harald

    2010-01-01

    What differentiates those who are able to adapt well to adverse life events (i.e., persons who are resilient) from those who are not (e.g., persons who develop post-traumatic stress symptoms)? Previous work suggests that enhanced autobiographical integration of trauma memories is associated with more severe post-traumatic stress symptoms. Extending this line of work, the present study looked at whether the integration of trauma memories, repressive coping and cognitive reactivity are related to post-traumatic stress symptomatology following negative life events among otherwise healthy young adults (N = 213). Results show that while enhanced integration of trauma memories and high levels of dissociation are related to elevated levels of post-traumatic stress, people who generally engage in repressive coping report fewer post-traumatic stress symptoms. Copyright (c) 2009 John Wiley & Sons, Ltd.

  18. The effects of trauma history, gender, and race on alcohol use and posttraumatic stress symptoms in a college student sample.

    Science.gov (United States)

    Marx, Brian P; Sloan, Denise M

    2003-12-01

    The present study examined the extent to which different types of traumatic experiences interact with sex and race to effect alcohol use, posttraumatic stress symptomatology, and general psychological distress among a college student sample. Approximately 600 participants completed measures that assessed for a childhood sexual abuse (CSA) history, alcohol consumption, posttraumatic stress symptoms, and overall psychological functioning. Findings indicated that participants with a history of CSA reported greater psychological distress and posttraumatic stress symptoms compared to participants with a trauma history other than CSA and participants with no trauma history. Despite group differences in psychological distress and posttraumatic stress symptoms, no differences in alcohol use were detected across groups. Gender appeared to affect posttraumatic stress symptoms as a function of group. The implications of the results are discussed.

  19. Depression, anxiety and stress in dental students

    Science.gov (United States)

    Binanzan, Najla; Alhassan, Aseel

    2017-01-01

    Objectives To measure the occurrence and levels of depression, anxiety and stress in undergraduate dental students using the Depression, Anxiety and Stress Scale (DASS-21). Methods This cross-sectional study was conducted in November and December of 2014. A total of 289 dental students were invited to participate, and 277 responded, resulting in a response rate of 96%. The final sample included 247 participants. Eligible participants were surveyed via a self-reported questionnaire that included the validated DASS-21 scale as the assessment tool and questions about demographic characteristics and methods for managing stress.  Results Abnormal levels of depression, anxiety and stress were identified in 55.9%, 66.8% and 54.7% of the study participants, respectively. A multiple linear regression analysis revealed multiple predictors: gender (for anxiety b=-3.589, p=.016 and stress b=-4.099, p=.008), satisfaction with faculty relationships (for depression b=-2.318, p=.007; anxiety b=-2.213, p=.004; and stress b=-2.854, pstress b=-2.854, pstress b=-2.648, p=.045). The standardized coefficients demonstrated the relationship and strength of the predictors for each subscale. To cope with stress, students engaged in various activities such as reading, watching television and seeking emotional support from others. Conclusions The high occurrence of depression, anxiety and stress among dental students highlights the importance of providing support programs and implementing preventive measures to help students, particularly those who are most susceptible to higher levels of these psychological conditions. PMID:28553831

  20. Health status and treatment–seeking stigma in older adults with trauma and posttraumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Anica Pless Kaiser, PhD

    2016-04-01

    Full Text Available This study compared health status across four trauma/posttraumatic stress disorder (PTSD groups of older adults with depression, anxiety, and/or at-risk drinking who attended primary care appointments (N = 1,199; mean age = 73.5 yr, mostly at Department of Veterans Affairs hospitals. The trauma and PTSD categories were PTSD (n = 81, partial PTSD (n = 127, trauma only (n = 323, and no trauma (n = 668. Physical and mental health-related quality of life (HQL, indices of social and economic impairment and stigma regarding treatment-seeking were compared among groups. Group differences were found for several indicators of functional impairment; the PTSD group had fewer close friends and higher treatment-seeking stigma beliefs related to having a disorder. Linear mixed modeling examined associations between trauma/PTSD group and HQL. After accounting for covariates, the trauma/PTSD groups differed across the Medical Outcome Study Short Form-36 scales and component scores (indicated by significant group by scale interaction. Differences among groups were confined to mental health measures; those with PTSD had worse HQL. Post hoc analyses examined the number of comorbid psychiatric diagnoses by trauma/PTSD group. Overall, findings indicate that mental HQL varies among older adults with trauma and PTSD and that although treatment-related stigma does not differ among groups, it does affect HQL.